AHA Coding Clinic® for HCPCS - 2018 Issue 2; Ask the Editor

Positive Cologuard

A patient has a Cologuard test, which was submitted with a screening diagnosis of Z12.11, Encounter for screening of for malignant neoplasm of colon. The results of the Cologuard test are positive and the patient is referred for a colonoscopy. Does the positive Cologuard test indicate a high-risk individual? The physician documents a “screening colonoscopy for positive Cologuard test.” Would the colonoscopy be reported with HCPCS code G0105, Colorectal cancer screening; colonoscopy on individual at high risk, or HCPCS code G0121, Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk? ...

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