HCPCS Range Screening Examinations and Disease Management Training

• 1 Cervical or vaginal cancer screening; pelvic and clinical breast examination ( G0101 )

• 2 Prostate cancer screening; digital rectal examination ( G0102 )

• 3 Prostate cancer screening; prostate specific antigen test (PSA) ( G0103 )

• 4 Colorectal cancer screening; flexible sigmoidoscopy ( G0104 )

• 5 Colorectal cancer screening; colonoscopy on individual at high risk ( G0105 )

• 6 Colorectal cancer screening; alternative to G0104, screening sigmoidoscopy, barium enema ( G0106 )

• 7 Diabetes outpatient self-management training services, individual, per 30 minutes ( G0108 )

• 8 Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes ( G0109 )

• 9 Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist ( G0117 )

• 10 Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist ( G0118 )

• 11 Colorectal cancer screening; alternative to G0105, screening colonoscopy, barium enema. ( G0120 )

• 12 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ( G0121 )

• 13 Colorectal cancer screening; barium enema ( G0122 )

• 14 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ( G0123 )

• 15 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician ( G0124 )