G0121 can be billed once every 10 years. Verify that the 45378 was billed for a problem and not screening (it should be a problem). If it was billed for a problem then they must have had a screening colo in the last ten years or even a flex sig. Medicare is pretty good about keeping up with this stuff. I have never known them to deny one of these for this reason in error but that has just been my experience. Hope this helps!
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