Section title: Requests for Interpretation
RFI #
895
270/271 colonoscopies coding
Description

We are being asked for specific benefits for screening and diagnostic colonoscopies in our 270/271 transactions. We are not seeing a specific benefit category in the 5010 guide. How should screening and diagnostic colonoscopy specific benefits be explicitly reported in the 271?

Response

When no service type code exists, use of EB13 to identify the appropriate procedure code in EB13-2 is the proper solution. If a range of codes is needed, identify the procedure code at the beginning of the range in EB13-2 and the procedure code at the end of the range in EB13-8. Use of the range of codes would indicate that any code in that range applies.

DOCUMENT ID
005010X279