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Screening colonoscopy through stoma

  1. Default Screening colonoscopy through stoma
    Medical Coding Books
    Is it appropriate to use the G0105 for a Medicare screening colonoscopy through the stoma? The patient has a history of rectal cancer. I wasn't sure if there is a G-code for through the stoma, or if G0105 is to be used since a colonoscopy is from the rectum to the cecum. Thanks in advance.

  2. #2
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    I was always told that G0105 and G0121 are equal to 45378 so I would not use it for your scenerio. Hope this helps!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  3. Default
    Yes, it is appropriate to use G0105 for a screening colonoscopy through the stoma. Your patient would be considered high risk.

    ~L
    CPC, CGSC, COSC

  4. #4
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    Treetoad - I would like to know where you have gotten your info? Medicare pays the G0105 at the same rate as 45378. Colo through stoma is not coded as 45378 it has it own set of codes. I dont see how you could code that as G0105. Maybe I am wrong but it just doesnt make sense to me. Thanks!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  5. Default
    Susie, I've got to be honest with you. I have a 3M encoder, which leads me in this direction. I understand that a diagnostic colonoscopy through a stoma has its own code. I don't have any actual documentation that states using G0105 as the correct procedure code. If anyone out there has documentation to support this, I'd love to review it.

    ~L
    CPC, CGSC, COSC

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