RE: Colonoscopy as part of tx eval

[Guest guest]

We consider the Polyp removal as " treatment " In addition, during heart cath, if

medication is prescribed (such as Nitro) then that too is considered " treatment "

and we have the patient's insurance or medicare billed. The patients are told

pryor to beguining any workup that any treatment would be filed with their

insurance, and that this includes polyp removal and such.

hope this helps.

Amellia Gay

East Texas Medical Center

Tyler TX

>>> " marcia Fisher " 9/10/2007 3:32 PM >>>

Hello,

I checked with our clinical staff and this is what they told me...during the

colonoscopy, even if they snipped a polyp, it is not considered " treatment " .

The polyp is sent for biopsy, and if positive for carcinoma, then they would

refer the patient for " treatment " based on the result of that test. Tests

like colonoscopy and heart caths (also a diagnostic procedure), seem like a gray

area...if no stent is placed during a cath, then it would be a diagnostic

procedure. If they do put in a stent, then it would be considered treatment.

Interesting subject... any other thoughts out there?

Marcia J. Fisher

Sr. Transplant Financial Coordinator

Michigan Transplant Center

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>>> " Vaughan " 9/10/2007 3:40 PM >>>

Hi,

Please remember, it is very, very important to communicate closely with the

patients and where not Medicare, the payer for the patient. The patient

needs to sign something that says that they realize that if care is given

(such as a polyp is snipped) that the patient and their payer is going to be

billed, if no care is given then the patient and payer will not get billed

(kidney only). For non kidney, non Medicare, you can do the service and

bill based on contract. However in any case, any hospital service must be

logged for inclusion on the cost report regardless of payer. You also may

need to get preauths and get the doc's to do the same just in case.

Thanks,

Bill

_____

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of

Sent: Monday, September 10, 2007 11:50 AM

To: TxFinancialCoordinators

Cc: Dodson

Subject: RE: Colonoscopy as part of tx eval

Can any let me know if colonoscopy are now being down at transplant center

as part of kidney tx pre eval ?

We have new physician who would like this done on all patients over age 50,

would like to find out if this is being done at other centers and put on

cost report.

Thanks

Financial Coordinator

Allegheny General Hospital

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