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Thread: Clarification needed regarding G codes for colos

  1. #1

    Default Clarification needed regarding G codes for colos

    AAPC: Back to School
    I receive the General Surgery Coding Alert. There is an article on Screening colonoscopies for Medicare. When discussing G0121 or G0105 codes someone is quoted saying "These codes also include any pre-scope office visit, so you cannot bill an E/M code when these codes are used". I cannot find any documentation to support this statement. Am I missing something? Our surgeons see the patient in the office first and then the colo is scheduled depending on the pateints prefrences. These visits are dropped to patient balance because they are screening and not covered. Any direction would be appreciated.
    Thank you

  2. #2
    Join Date
    Apr 2007


    I code for the facility side so don't take my word as gospel. I believe the point is that there are no complaints or symptoms for a true screening. And complaints or presenting problems are a required component of E/M codes. Some insurance companies may pay for preventative medicines codes, but I don't believe Medicare does. I hope this helps and someone with more experience chimes in.
    Juanita Mendoza, CPC

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