What is the status of Medicare coverage of virtual colonoscopy?
At this point and time the Medicare colon cancer screening benefit consists of fecal occult blood testing (FOBT), sigmoidoscopy, colonoscopy, and barium enema, as applicable. Virtual colonoscopy is not included. Also, based on the evaluation of peer reviewed literature and technology assessments, this is currently considered an investigational service. Any time providers bill for a service that is statutorily excluded or does not meet the definition of any Medicare benefit, they may append modifier GY. When billing for a virtual colonoscopy, an unspecified code should be used (as there is no designated code).
