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G codes is must or not for 45378

  1. #1
    Default G codes is must or not for 45378
    Medical Coding Books
    Hi All,

    Im working for Gastroenterologists,Im having some doubts which was mentioned below.Please check with those and advice me.

    1.Is it necessary to change all 45378 to G0121 or G0105 for Medicare?

    2.If we bill G0121 instead of 45378 for Inpatient means, in most cases Medicare denied it stating Wrong Place of Service.So please confirm me that what code we have to use for Inpatient's with 45378?

    3.As per LMRP, we should link only V76.51 for G0121.If there is any other dx for same patient means we are not suppose to link them.Is it right?

    Thanks in advance...

    Warm Regards,

  2. Default
    You would never bill g0121 for an inpatient situation. What would be the medical necessity for a screening colonoscopy in the inpatient setting?

    45378 is used when the colonoscopy is considered a diagnostic colonoscopy for Medicare.....patient has rectal bleeding, diverticulosis, etc., you would not use the G-codes if the patient has problems/symptoms and the procedure is being done to evaluate those. The G-codes are ONLY used for SCREENING colonoscopies. 45378 could be used for inpatient or outpatient services for Medicare.

    You are correct that V76.51 would only be linked with G0121. If a screening turns diagnostic, i.e. polypectomy, etc., is done you would list V76.51 primary but not link it.

  3. #3
    Thanks a lot..

    Is there any more information related to G codes for 45378..

    Thank you all in advance


  4. Default G Codes
    The best place to find information regarding 45378 and G codes for Medicare is to access the LCDs for your state for screening and diagnostic colonoscopies and follow them when you are coding colonoscopies. Reading through them should help you to better understand when to use 45378 vs the G codes (G0121 and G0105).

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