Medicare waives patient cost-sharing for anesthesia in screening colonoscopies: What providers need to know

Anesthesiologists providing care for a Medicare patient undergoing a screening colonoscopy, will be able to collect 100 percent of the allowable amount from Medicare, beginning on Jan. 1, however, providers must identify the service as screening rather than diagnostic or therapeutic through the use of the appropriate modifier on the claim, according to an Anesthesia Business Consultants blog post.

In the 2015 Physician Fee Schedule Final Rule, CMS extended the waiver of coinsurance and deductible for anesthesia services furnished in conjunction with a screening colonoscopy. Diagnostic or therapeutic colonoscopies, on the other hand, continue to require co-payments and deductibles.

Thus, anesthesiologists have to be careful to note the correct modifier on claims, especially in situations where the procedure begins as a screening, but in which a polyp or other tissue is found and removed. Anesthesiologists will have to document carefully to ensure that they are using the correct modifier. The anesthesiologist may want to corroborate the nature of the procedure with the gastroenterologist, notes the blog post.

Medicare waives patient cost-sharing for anesthesia in screening colonoscopies: What providers need to know

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