Wiki Medicare denied colonoscopy

[tholcomb]

Good afternoon fellow Coders,

Patient had EGD and colonoscopy done on the same date the EGD was paid and the colonoscopy G0121 was denied due to the contracted maximum number by the same provider any clues as to why this was denied?

Thank you,
TH

 

[dsheets07]

G0121 is only a benefit once every 10 years. It is my suggestion that you have the patient sign an ABN waiver on any services that are limited by frequency or timing in the event the provider is unaware the patient has exhausted this benefit. The link below provides you with complete information regarding screening colonoscopy.

http://www.cms.gov/Outreach-and-Edu...LNProducts/downloads/mps_guide_web-061305.pdf

This link is an invaluable resource for coverage for Medicare Preventive Services.