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G0102 Digital Rectal exam for Postrate Cancer Screnning

  1. Default G0102 Digital Rectal exam for Postrate Cancer Screnning
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    When I bill procedure code G0102 with diagnosis code V76.44 , I receive denial from medicare with reasons that "claim/service lacks informatiom which is needed for adjudicaation." Can someone please explain what I'm doing wrong.


  2. Default G0102
    I was looking into to this today and found the "Claims Processing Manual" on CMS website, this is what I found:

    50.3.1 - Correct Coding Requirements for Carrier Claims
    (Rev. 1, 10-01-03)
    Billing and payment for a Digital Rectal Exam (DRE) (G0102) is bundled into the payment for a covered E/M service (CPT codes 99201 - 99456 and 99499) when the two services are furnished to a patient on the same day. If the DRE is the only service or is provided as part of an otherwise noncovered service, HCPCS code G0102 would be payable separately if all other coverage requirements are met.

    *** If you look at this manual it tells you what the correct ICD is and any remit advice remarks that this code might generate "16" was not on eof them. Only that it is an annual test and pt must be over 50 to qualify. Sorry I could not be of more help.

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