Issue link: https://beckershealthcare.uberflip.com/i/624121
26 Coding, Billing & Collections T he Centers for Medicare and Medicaid Ser- vices' 2016 Physician Fee Schedule Final Rule includes reimbursement cuts for colonoscopy. e cuts were initially proposed in July and several societies, including the American Gastroenterologi- cal Association, American College of Gastroenterol- ogy and American Society of Gastrointestinal En- doscopy worked with CMS to mitigate the cuts. "I think the cuts will adversely affect the ability of some gastroenterologists to provide services," says David Greenwald, MD, director, clinical gastroen- terology and endoscopy, e Mount Sinai Hospital in New York City. "Colonoscopy provides an ef- fective way to diagnose and treat a wide variety of gastrointestinal conditions. Cutting reimbursement for colonoscopy may make it more difficult for many gastroenterologists to provide these potentially life- saving procedures in a cost-effective manner." However, several cuts were still in the final rule, including some that are more than 17 percent. e top 10 lower GI codes include: 1. Colonscopy with snare polypectomy (CPT code 45385): -12 percent 2. Colonoscopy (CPT code 45373): -9 percent 3. Colorectal cancer screen, high risk (CPT code G0105): 0 percent 4. Colorectal cancer screen, low risk (CPT code G0121): 0 percent 5. Colonoscopy with hot biopsy (CPT code 45384): -11 percent 6. Colonoscopy with submucosal injection (CPT code 45381): -13 percent 7. Flexible colonoscopy with ablation (CPT code 45388): -15 percent 8. Flexible sigmoidoscopy with biopsy (CPT code 45331): -1 percent How Medicare Colonoscopy Reimbursement Cuts Could Impact GI in 2016 & Beyond By Laura Dyrda Dr. David Greenwald Dr. Noel Fajardo Improving health care quality through accreditation Contact us to learn more 847-853-6060 • info@aaahc.org • www.aaahc.org A A A H C A C C R E D I T A T I O N { } It's designed for the provider who always wants to be better. We send physicians, nurses, administrators – professionals who understand your world. They can help you raise the bar on patient care. • We are the leader in ambulatory accreditation. • Our Standards are nationally-recognized. • Our surveys are consultative not just a checklist.