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G Codes for a Medicare HMO?

  1. #1
    Default G Codes for a Medicare HMO?
    Medical Coding Books
    Good Afternoon,
    I have a patient who has Secure Horizons Medicare HMO and they presented for a colon screening. The colonoscopy was normal. We billed with code 45378 but this has now denied as not medically necessary to the WPS colonoscopy LCD L30304. Of course, the V7651 is not included in that because when you bill a screening to Medicare it will be with a G code.

    Can you bill the G screening codes to Medicare HMOs?

    Missy Heuer CPC, CIRCC, CANPC

  2. #2
    It depends on the carrier, but I have found with that particular one that they use mostly Medicare codes. So I would say yes, you can. :0)

  3. #3
    Missy Heuer CPC, CIRCC, CANPC

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