wmf213
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Can anyone help me on coding coloscopies for ASC? Using the G0105/G0121 with Medicare and BCBS has got me stumped. Is BCBS paying for the G codes? I would appreciate any help. Thank you.
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Wiki Coding Colonscopies at ASC
- Thread starter wmf213
- Start date
Use the G0105 and G0121 for MEDICARE PRIMARY When the patient has BCBS as secondary the claim crosses over and they will pay it. DO NOT BILL the G codes unless MEDICARE is primary.
also to add something check your contracts on occasion the commercial ins would like you to use the G code for the screenings however it is not very often.
also to add something check your contracts on occasion the commercial ins would like you to use the G code for the screenings however it is not very often.
colonoscopy in ASC
In our area, BCBS uses the G codes as well so any Medicare and BCBS patients we have with screening colonoscopies are coded:
High risk- G0105
other - G0121
If the physician ends up taking biopsies during the procedure or ablating a polyp we do not use the G code but code it with the correct CPT code for the procedure and then add modifier PT to indicate that the case started out as a screening. The doctors claim will have modifier 33 to indicate it started as a screening.
In our area, BCBS uses the G codes as well so any Medicare and BCBS patients we have with screening colonoscopies are coded:
High risk- G0105
other - G0121
If the physician ends up taking biopsies during the procedure or ablating a polyp we do not use the G code but code it with the correct CPT code for the procedure and then add modifier PT to indicate that the case started out as a screening. The doctors claim will have modifier 33 to indicate it started as a screening.