AAPC - Back to school
Page 2 of 2 FirstFirst 12
Results 11 to 12 of 12

Thread: Back to 45378 vs. G0105

  1. #11
    Join Date
    Apr 2007
    orange, ca


    AAPC: Back to School
    Quote Originally Posted by coachlang3 View Post
    No, if the patient came in for a screening the proc code would be G0105 and V12.72. The pt is high risk (G0105) due to previous findings (V12.72). The only time you would need to code the 45378 would be if the patient presented with current symptoms but there were no findings. This is for Medicare. However, other insurances don't like the G codes so you would need to use the 45378.
    i agree with this from coachlang.....and also, medicare will not pay for the screening G0105 when billed/coded with the V76.51, we have been getting plenty of denials for medical necessity but they will pay for the V12.72 along with the V10.05, V10.06 and V16.0....there are limited V-codes that warrant payment from medicare.

    And yes, G codes are only for Medicare...other ins will need to be billed the 45378

  2. #12

    Default What if

    Very often I have pt's that have their colonoscopies for screenings, and the only finding is diverticulosis w/out hemorrhage (not a covered dx). Is this still a screening since the dx isn't a covered one and what code would i use?
    adrianne, cpc

Page 2 of 2 FirstFirst 12

Similar Threads

  1. RFA on back to back days
    By missyah20 in forum Anesthesia
    Replies: 3
    Last Post: 12-04-2014, 10:38 AM
  2. G0105 vs 45378
    By Telcontar82 in forum Gastroenterology
    Replies: 3
    Last Post: 05-31-2013, 12:33 PM
  3. Back Pain, Back Spasm
    By msekarinfo in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 11-15-2012, 11:22 PM
  4. G0121 and g0105
    By kim culp in forum Gastroenterology
    Replies: 5
    Last Post: 06-20-2011, 10:40 AM
  5. 45378 vs. G0105
    By rcclary in forum Gastroenterology
    Replies: 6
    Last Post: 02-20-2009, 06:17 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.