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.
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