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.
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