Billing and Coding: Diagnostic Colonoscopy

This billing and coding article references LCD L38812 and states that diagnostic colonoscopy is covered when reasonable and necessary per the LCD. It emphasizes that non-covered services must not be billed as covered (use appropriate modifier) and specifies detailed medical record requirements including legibility, patient identifiers, provider signatures, code-supporting documentation, procedure and pathology reports, and documentation when the procedure is incomplete or performed by a different provider.

"Diagnostic colonoscopy is covered when determined to be reasonable and necessary in accordance with Local Coverage Determination L38812."

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