We have some patients come into the office and see a mid-level provider and decide to do their screening colon. We hold onto the claim until after they are seen, and then mark it as inclusive to the screening colonoscopy done, with a zero fee. Then we have other patients who come in, hem and haw about getting a colonoscopy done, and after holding it the 30 days we bill them out. I do not believe this is the correct way to go about this (these are traditional Medicare patients I am speaking of). I know we do not bill the patient if Medicare denies, so we end up eating the cost. My issue is that the facility side is paid but not the professional side. We have nothing else to code except the Z12.11 because they ARE symptomatic and just coming in as a pre-colonoscopy visit. What are others doing with regards to this type of visit?