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Urology Coding Alert

Reader Question:

Digital Rectal Exam and E/M Code

Published on Wed Mar 01, 2000

Question: Can we bill for a digital rectal exam and an E/M code?

Anonymous Maryland Subscriber

Answer: Now that Medicare allows a digital rectal exam for prostate cancer screening (G0102), this question is coming up more often. The answer is no. And the next question is, should you use G0102 or an office visit code? Its true that G0102 is for a digital rectal exam. But what patient just comes to your office for this? Instead, you would probably be better off billing an office visit (99201-99215). Code using diagnosis codes representing the patients signs and symptoms (dysuria, 788.1 or 306.53; nocturia, 788.43; etc.). Note that an office visit code pays better than G0102.

Tip: Code G0102 was created for prostate cancer screening clinics, where that is essentially the only service provided.
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