Brandigirl |
10-18-2019 10:10 AM |
I don't know how it works in Florida. In GA if you are under Medicare age and have work issued health insurance and have a positive Colorguard, the coding for the colonoscopy will be "diagnostic colonoscopy or positive colorguard". This means you have to meet your out of pocket deductible first. Most insurance will pay for a "screening colonoscopy", meaning that you either never had a colonoscopy before or you have had a negative colonoscopy in the past. So, according to GI doctors I know in GA, it is better to get a colonoscopy so it can be coded as "screening" as long as you meet the criteria I listed above. Now if you ever had a history of polyps, you will always be coded under history of polyps. So it will always be considered a diagnostic colonoscopy going forward in most cases. Now, if you go in for a "screening colonoscopy" and they find and remove a polyp, call your insurance company (under Medicare age) and let them know you had no history of polyps prior and it was a "screening colonoscopy" and most likely that will not change the coding to diagnostic and it will be covered under your preventative care. Now, things might have changed regarding this so this is just a little background on it.
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