Forum - Questions & Answers

Nov 13th, 2009 - tipy

colonoscopy and medicare

How long must a patient wait to get another colonoscopy that will be paid by medicare without a problem?

Nov 13th, 2009 -

I don't think there is a "global period"

but I would not use the screening code for each one. And Be sure the Op note clearly indicates why it is being done sooner than 5-10 years.

Nov 15th, 2009 - Codapedia Editor 1,399 

Colonoscopy: screening

Medicare follows the US Preventive Task Force recommendations for screening colonscopy. (Diagnostic colonoscopies are paid as indicated by the patient's symptoms.)

You can download the "how often" from the Codapedia article on preventive medicine. The article is title "Preventive Medicine services for Medicare patients" Then, download the chart.

From my memory, low risk, no risk factors, no previous history: every ten years.

When the patient has had a polyp removed or has a family history, it is more frequent (five years?)

You can also look this up in Publication 100-04, chapter 18 at

http://www.cms.hhs.gov/manuals/iom/List.asp



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