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New to GI------Colonoscopy for Medicare HELP!!!

NancyZ76

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Hi, I am new to GI coding can anyone give advice on billing colonoscopy's for Medicare PLEASE!

Are they codes G0121 and G0105, are these both for a screening and a diagnostic???? Also I read in the HCPS book that if a biopsy is done the 45380 codes should be used instead

Any help and knowledge is appreciated
 
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Screening Colonoscopy

Hi Nancy,

Yes those codes are used for Medicare screenings. G0105 is for patients at high risk and G0120 is for patients considered at low or normal risk.

If the provider does a screening and performs a procedure to remove a polyp then it is no longer a screening and you should use the appropriate CPT code instead of the G code. I found some information at CMS that hopefully is helpful to you. Good Luck! :)

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/.../R1735B3.pdf

Alayne
 
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