Medicare LCD Exercise #3
Name: Access the following website, search for the policy, review the policy, and answer the questions pertaining to the policy.
https://www.cms.gov/medicare-coverage-database/search.aspx
Find policy A52378 What is the name of this policy (1 point
)? Billing and Coding: Colorectal Cancer Screening – Medical Policy Article
1.
Code the following visit then refer to this policy and determine if it’s covered (3 points).
Colonoscopy due to blood in stool
CPT: 44391 CM: K62.5
Covered? Why or why not? No because it wasn’t stated that it was a cancer screening or diagnostic. Also, the policy is retired.
2.
Code the following visit then refer to this policy and determine if it’s covered (3 points).
Diagnostic sigmoidoscopy with a diagnosis of excessive flatulence
CPT: 45330 CM: R14.3
Covered? Why or why not? No because although it was diagnostic, the codes are not covered. Also, the policy is retired.
