Gastroenterology Coding Alert

Your G0105 pay hinges on sticking to your carrier's approved diagnoses. You can get a screening colonoscopy covered more often than once a decade if the patient meets the carrier's high-risk guidelines. Check out this primer on high-risk diagnosis patients, and ensure your G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) pay every time. Crohn's, Colitis Can Equal High Risk According to Medicare, a patient at high risk for colorectal cancer is eligible for a screening colonoscopy once every 24 months. Note: Medicare eligibility for high risk screening colonoscopy does not equate to appropriate or necessary care. The American Cancer Society and the American College of Gastroenterology both have guidelines listing intervals for surveillance colonoscopy for specific conditions. Go to www.cancer.org/docroot/ped/content/ped_2_3x_acs_cancer_detection_guidelines_36.asp or www.acg.gi.org/media/releases/ACG2009Colon  CancerGuideline.pdf for more information. An individual at high risk for developing colorectal cancer has one or more of the following, confirms Cynthia Swanson, [...]