Wiki Screening colo billed with G0121

[sjh72]

Hoping someone can help answer the following question.

My understanding when billing a screening colo where nothing is removed, 45378 would be billed for commercial insurance and G0121/G0105 is billed for Medicare/Medicare Advantage.

However; it has been suggested that ALL screening colo's (where nothing is removed) should be billed with HCPSC codes. These are performed at the hospital as outpatient procedures.

Is this correct? Can you point me to the literature supporting this coding?

Thanks-

 

[mitchellde]

The G codes for screening colonoscopy are payer discretion allowed. It really depends on the payer as to which code they prefer for the screening colonoscopy. I have found that most commercial do prefer the G code.

 

[sjh72]

Thank you very much!!

 

[CICIB]

If your payer doesn't pay the G codes try using 45378 with Mod -33. Just a thought.