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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Article Overview
This article focuses on colorectal cancer screening workflow after a positive Cologuard result. It is aimed at coders, billers, and clinical documentation staff who need to understand how the screening diagnosis, test result, and follow-up colonoscopy are discussed in relation to HCPCS colorectal cancer screening codes and screening diagnoses. The discussion is limited to general coding relevance and does not replace the premium article’s detailed guidance.
Why This Topic Matters
A positive noninvasive screening result can change how the follow-up procedure is interpreted in coding and billing workflows. Understanding the article’s scope helps readers assess whether it applies to their documentation and claim-selection questions.
What You Will Learn
- How the article frames a positive Cologuard screening result in relation to follow-up colonoscopy coding
- Which colorectal cancer screening coding questions the article addresses
- How screening diagnosis context is discussed for the follow-up procedure
- What general coding issue is raised when a positive screening test precedes colonoscopy
Who Should Read This
- Medical coders
- Billing staff
- Compliance staff
- Clinical documentation improvement specialists
- Colorectal screening program staff
Codes Discussed
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