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G0102 - Prostate cancer screening

  1. #1
    Lebanon, NH
    Default G0102 - Prostate cancer screening
    Medical Coding Books
    Good morning - I keep reading that G0102 is supposed to be covered for Medicare beneficiaries, but I have never been able to get it paid. How exactly does it have to be billed? Thanks!

  2. #2
    We use G0103 for Medicare Prostate screening with V76.44. If results are elevated, we use 84153 with 790.93. G0103 does get paid.

  3. #3
    Lebanon, NH
    I'm talking about the digital rectal exam, G0102, that is supposed to be one of the very few 'preventive' measures Medicare covers.

  4. #4
    We have found that G0102 is usually bundled into the E/M code and is not reimbursed separately, even if you use modifier 25 on the E/M.

    I hope this helps.
    Teresa Collins, CPC

  5. #5
    We as well have found that it will deny when the E/M pays...

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