Wiki Medicare Colonoscopy

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medicare colonoscopy

Medicare guidelines state that if you are in a high risk group that they will cover a colonscopy one time in a 24 month period. High risk is someone that has had colon ca, polyps, fh of colon cancer. :(
 
Thanks

Thanks Sharon. The first colonoscopy was done last June and the biopsy is what detected the colon cancer. So they would need to wait til next June even if an oncology doctor is recommending it? Correct?
 
I would think that if the cancer is still present or if the patient has just finished treatment it would not be a screening, I think those guidelines only apply to screenings.
 
We always do colonoscopy at one year mark after colon ca. The one at the one year mark is coded as 45378 with dx/code V10.05. The ones after that would be the high-risk screening with the G0105 and V76.51 and V10.05.
 
I also agree that a one year follow up after dx of colon cancer is a follow-up colonoscopy, not a screening. Our Dr's also have our patients come back in a year after dx.
 
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