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Coding Colonscopies at ASC

  1. Default Coding Colonscopies at ASC
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    Can anyone help me on coding coloscopies for ASC? Using the G0105/G0121 with Medicare and BCBS has got me stumped. Is BCBS paying for the G codes? I would appreciate any help. Thank you.

  2. #2
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    Use the G0105 and G0121 for MEDICARE PRIMARY When the patient has BCBS as secondary the claim crosses over and they will pay it. DO NOT BILL the G codes unless MEDICARE is primary.

    also to add something check your contracts on occasion the commercial ins would like you to use the G code for the screenings however it is not very often.
    LG CPC,CASCC

  3. Default colonoscopy in ASC
    Quote Originally Posted by wmf213 View Post
    Can anyone help me on coding coloscopies for ASC? Using the G0105/G0121 with Medicare and BCBS has got me stumped. Is BCBS paying for the G codes? I would appreciate any help. Thank you.
    In our area, BCBS uses the G codes as well so any Medicare and BCBS patients we have with screening colonoscopies are coded:
    High risk- G0105
    other - G0121

    If the physician ends up taking biopsies during the procedure or ablating a polyp we do not use the G code but code it with the correct CPT code for the procedure and then add modifier PT to indicate that the case started out as a screening. The doctors claim will have modifier 33 to indicate it started as a screening.

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