New billing guidance for follow-up colon cancer screenings
When one of our members requires a follow-up colonoscopy after a positive, non-invasive stool-based screening test or direct visualization screening test, we cover this follow-up procedure and any resulting biopsies or pathology without member cost share.
How should you bill the follow-up test?
If you’re billing for a follow-up colonoscopy that meets the requirements noted above, you should:
- Bill as diagnostic, as you would normally
- Add modifier PT or 33 to indicate that it’s preventive