Wiki E/M prior to screening

[ashley.roberts@nchmd.org]

Hi Everyone!

What are you doing in your Gastro practices for an E/M prior to a colonoscopy if the only reason the patient is seen is for a history of polyps and to schedule the procedure? I found this AAPC website that shows regardless if it's a new patient an E/M prior for an asymptomatic patient is not separately reportable but I wanted to see if this is the guideline other offices follow.

Thank you for your help!

https://www.aapc.com/blog/27288-separate-em-with-screening-colonoscopy-plus-pre-op-screenings/

 

[pamsbill]

Most of the practices I know do not charge for the visit. Some insurance policies have an actual benefit for an office visit prior to a screening. Some practices will bill for those visits, if the patient's policy allows for it. I am not sure I agree with billing for it, since it is inconsistent IMO.

What I see with most of the practices is something called direct access or open access screening colonoscopies. The patient can sign up online and obtain the prep and show up for the procedure without ever having been in for an office visit. This is only for patients who have no GI symptoms and no cardiac issues though.