I work for a Rural Health multi-specialty practice group. I have a Medicare claim that has been denied for not medically necessary. This is a surgeon who was consulted to see this patient strictly for a screening colonoscopy.
The patient had never had a colonoscopy before & no presenting symptoms either. Medicare effective date & DOS only 51 days apart. The dictation does not state this is a Welcome to Medicare colonoscopy visit.
The charges were a level 3 office visit & V76.51.
Medicare denying for medical necessity for Dx V76.51 but as stated there isn't any symptoms to code. Is there a different CPT code for a Welcome to Medicare visit that I am missing?
Thank you all for any insight on how to code this Welcome to Medicare Colonoscopy screening OV.
LImparato, CPC, AAS
Welcome to Medicare Colonoscopy Screenings
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