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Gastroenterology Coding Alert

Colon Cancer Screening:

G0121 Offers the Best Choice for Coding Colon Cancer Study

Published on Mon Sep 20, 2010

Frequency rules vary for average, high risk patients. If you're coding for colorectal cancer screening and worrying that your payer won't accept them, your protection could lie on following frequency guidelines and eligibility requirements exactly as instructed. Could these 4 facts have the coding answers you're looking for? Read on! 1. Average Risk Patients Qualify for Colorectal Cancer Test If the patient is at least 50 years old, he is eligible for a covered Medicare screening. These patients are considered average risk, and can have a colon cancer screening only once every 10 years, says Cheryl Ray, CCS, CPMA, of Atlantic Gastroenterology in Greenville, N.C. Red flag: It's once in 10 years or nothing to most payers -- never more. Ignoring these frequency guidelines can spell trouble. Example: A 68-year-old established Medicare patient reports for a screening colonoscopy on Dec. 5, 2009. The patient's records indicate that he last had a [...]
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