New Billing Instructions for Colorectal Screening Services
Billing instructions for colorectal screening services will soon change. The new billing instructions apply to screening services provided to hospital inpatients submitted under Medicare Part B or when Part A benefits have been exhausted.
Effective Oct. 1, 2010, providers should report 12X TOB instead of 13X TOB when submitting claims for screening colorectal services to fiscal intermediaries (FIs). This applies to the following CPT® and HCPCS Level II codes:
82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)
G0104 Colorectal cancer screening; flexible sigmoidoscopy
G0105 Colorectal cancer screening; colonoscopy on individual at high risk
G0106 Colorectal cancer screening; alternative to G0104, screening sigmoidoscopy, barium enema
G0120 Colorectal cancer screening; alternative to G0105, screening colonoscopy, barium enema
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous determinations
The Centers for Medicare & Medicaid Services (CMS) Transmittal 1953, Change Request (CR) 6760, issued April 28 notifies fiscal intermediaries (FIs) of this change to billing instructions in Pub. 100-04, chapter 18, section 60, subsection 60.6 of the Medicare Claims Processing Manual.