Coding Guidance for Anesthesia for Screening Colonoscopy

CMS recently released  MLN (Medicare Learning Network) Matters® Number: MM8874 to provide instruction on how to report anesthesia associated with screening colonoscopy  and other preventative and screening services for which deductible/co-pay have been waived starting in 2015.  When reporting anesthesia in conjunction with procedure code G0105  and G0121, remember to append Modifier 33  -  Preventative Services - to anesthesia code 00810 when the service qualifies for waiver of the deductible/co-pay. The MLN piece is available at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8874.pdf

As part of the proposed FY 2015 Medicare Fee Schedule, ASA supported the proposal by the Centers for Medicare and Medicaid Services (CMS) to classify anesthesia for a screening colonoscopy  as an essential benefit.  ASA recommended that physicians be permitted to bill for the service using the current base + time payment methodology.  CMS subsequently finalized that proposal  and will start to implement it on January 1, 2015.