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Diverticula with colon screenings

Selina Posted Tue 01st of March, 2016 23:12:14 PM

Hello, If a patient has diverticulosis and family hx of col ca documented on previous colonoscopy reports (2008 and 2003), are we still able to bill a G code and screening dx to Medicare? And include the diverticulosis and fa hx codes 2nd and 3rd? Thanks!

SuperCoder Answered Wed 02nd of March, 2016 01:45:57 AM


Yes, you can bill G code and screening dx to Medicare as beneficiaries at high risk for developing colorectal cancer are eligible once every 24 months. Medicare considers an individual at high risk for developing colorectal cancer as one who has one or more of the following:
• A close relative (sibling, parent or child) who has had colorectal cancer or an adenomatous polyp.
• A family history of familial adenomatous polyposis.
• A family history of hereditary nonpolyposis colorectal cancer.
• A personal history of adenomatous polyps.
• A personal history of colorectal cancer.
• Inflammatory bowel disease, including Crohn’s Disease, and ulcerative colitis.
Other diagnosis codes can also be billed after screening code.

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