Posted and filed under Coding, Fraud, FWA, Healthcare.

Fraud Spotlight: The Use & Abuse of Modifier 25

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  Modifier 25.  It has been the bane of existence for fraud, waste and…

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Posted and filed under Coding, Medical Record Auditing.

Overview of Colonoscopy Coding

Diagnostic Colonoscopy A diagnostic colonoscopy is a test performed as a result of an abnormal finding, sign, or symptom (such as diarrhea, abdominal pain, etc.). Factors for Consideration: Symptoms before the procedure such as a change in bowel habits, rectal bleeding, etc. Findings during the procedure (polyp, cancer, diverticulosis, etc.) Personal history of cancer or…

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