Gastroenterology Coding Alert

Question: For one of our Medicare patients, our gastroenterologist performed a sigmoidoscopy in the office as part of a routine colon cancer screening. Should I be including a sigmoidoscopy procedure code such as 45330 with the claim?

Washington Subscriber

Answer: Yes, you should report the sigmoidoscopy but not with a code from the 45330 (Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)) to 45350 (Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)) range. For Medicare patients, you must use G0104 (Colorectal cancer screening; flexible sigmoidoscopy) for a screening sigmoidoscopy rather than using a code from the 45330 to 45350 series.