Wiki medicare problems

[ekfannin]

I work for an anesthesiologists office and we are having a problem getting medicare to pay for routine colonoscopies done in the hospital. the only code that fits is V76.51 but they reject that saying they don't approve routine screenings. Has anyone else had this problem and were you able to find a solution?

 

[teresabug]

Are you using the G codes for either low risk or high risk?

 

[ekfannin]

No would the anesthesiologist need the G code? I thought that was only for the surgeon

 

[teresabug]

I was just researching this and just realized you're talking about 001XX anes codes, I'm sorry. Long day ...
Medicare does cover screening colonoscopies but there was an article I read recently where MCR is going to include the reimbursement for the anes in with the actual colonoscopy.

 

[ekfannin]

Do you know where I could find that Article? I would love to read it. Because if that is the case then it still shouldn't affect the professional services for the anesthesiologist. Do you think if you used a 26 mod it would be processed for the professional side of it?