Important information about billing colonoscopy and related anesthesia services
The following services are covered with no member cost share:
- The colonoscopy screening procedure.
- Anesthesia charges when anesthesia is billed with the appropriate screening CPT code (even when polyps are removed).
- Other associated facility charges when the colonoscopy is billed with an appropriate screening diagnosis code.
- When polyps are removed during a screening colonoscopy - the removal, examination and analysis of the polyps.
In the instance where a screening colonoscopy starts out as screening but turns into a diagnostic procedure due to polyps being removed, BCBSGa follows CPT guidelines for our Commercial members, not Medicare guidelines. The CPT® 2018 Professional Edition manual shares the following information regarding the billing of anesthesia for any screening colonoscopy, “Report 00812 to describe anesthesia for any screening colonoscopy regardless of ultimate findings.”
August 2018 BCBSGa Provider Newsletter