How Many Days Need to Pass Before a Second Procedure is Fully Reimbursed?

Q: How many days generally need to go by before a second procedure is fully reimbursed? For example, if a patient has an EGD today, when can colonoscopy be scheduled for 100 percent reimbursement?

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Kathleen Mueller, RN, CPC, CCS-P, CMSCS, PCS: Generally, only one day needs to pass before payors will fully reimburse for a second procedure.

Ms. Mueller is an independent consultant with AskMueller Consulting LLC. She can be reached at askmueller@aol.com.

The information provided should be utilized for educational purposes only. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

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