Wiki Colonoscopy procedure CPT/ICD-10 codes for Medicare (First Coast Service Options) FL

[Huong81]

PT presented for screening colonoscopy, procedure turned out normal. Colonoscopy CPT will be billed as G0121 with Dx: Z12.11 or PT with history of colon polyps, procedure turned out normal. Colonoscopy CPT will be billed as G0105 with Dx: Z86.010. Medicare started deny claim " This is a non-covered service because it is a routine/preventative procedure" ??? Anyone have the same denials for Medicare patients in Florida? I checked LCDs for Medicare (First Coast Service Options) in Florida but I don't find any changes. Please advised, Thank you so much.

 

[jamierenay]

screening colons

are your denials all medicare payers across the board? when I worked for the GI practice we would get the PR49 denials on patients that had a colon before the 24 months. If the NCD hasn't changed is there possible a new Article or Lcd that became effective? I am under Palmetto and the G0105 and Z86010 passes med nec as long as the age and 24 months have been observed.