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  • 1.  Virtual Colonography and medical necessity guidelines

    Posted 01-08-2021 11:35
    Wondering how other imaging providers handle Virtual Colonography CT's (VC) that are referred with indications not meeting medical necessity as listed in CMS LCD's.  
    • If ordered as a diagnostic without meeting medical necessity guidelines, do you move ahead by having patient sign an ABN?   or
    • Do you contact RP to notify of issue with medical necessity and discuss screening VC options?
    I sincerely appreciate your feedback,

    Vicki Melendez

    Compliance and HIPAA Privacy Officer


    Radiology Regional 

    3660 Broadway, Ft. Myers, FL 33901

    E: vmelendez@radiologyregional.com

    O: (239) 936-2316

    C: (239) 980-3656





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  • 2.  RE: Virtual Colonography and medical necessity guidelines

    Posted 01-08-2021 11:46

    We had this discussion a couple of years ago when I was in another group. If you are doing the virtual on the same day as the failed colonoscopy, getting an ABN/waiver signed prior to the virtual is problematic as the patients have been sedated.  You should not be getting a waiver signed if a patient has already been sedated. We worked with the referring docs to try to get the ABN/waiver at the time of the colonoscopy.  Those changes however happened just prior to the group merging with another and deciding the business office could be outsourced so I don't know how things then transpired.

     

    Ruby O'Brochta-Woodward BSN, CPC, CPMA, CPB, CPC-I, COSC, CSFAC, RCC

    Certified Medical Coder and Educator| Consulting Radiologists, Ltd.

    7505 Metro Blvd. | Suite 400 | Edina, MN | 55439

    Phone:  612.573.2223 | Fax:  612.573.2250

    ruby.obrochtawoodward@crlmed.com

    www.consultingradiologists.com


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