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Screening Colonoscopy

  1. Question Screening Colonoscopy
    Medical Coding Books

    I billed a medicare pt for G0121- pt also has medical assistance secondary which does not recognize the G0121. Can you change a procedure to 45378 so that the secondary insurance will recognize it without resubmitting to Medicare because you changed a code?

    Any suggestions would be much appreciated.


  2. #2
    does the claim crossover to the 2ndary? Do you send the Medicare EOB?

    In either case, the 2ndary will see that you have changed the code and probably deny for the descrepancy.

  3. Default
    I am not sure on the cross over or if the billing company send the EOB. I don't get to see the denials. The billing company is requesting me to either change the code or okay a write off.

  4. #4
    I am in Virginia and I have not had any issues with Medicaid paying for the G codes after Medicare pays. I think I would ask for a copy of the denial and call Medicaid yourself. You should not have to change any codes. They need to get it straight in their system that G codes are the same as 45378.
    Susie Corrado, CPC
    ENT Coding/Billing

  5. Thumbs up Sasikala
    Here you can change code to secondary insurance. Because we are doing the same in Texas client and getting payment from the commercial carriers.

    Thank you
    Sasikala - CPC

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