tci Part B Insider - 2010 Issue 40

Reader Questions: G0121 Accepts No Other ICD-9 But V76.51

Question: A 73-year-old established Medicare patient with average risk for colorectal cancer presents for a screening colonoscopy on Feb. 11, 2010. The patient's records reveal his last covered screening to be on Jan. 31, 2000. How should I report this scenario?Answer: On the claim, you should report G0121 (Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk). But make sure there is no need or any therapeutic intervention during the colonoscopy.Heads up: Diagnosis coding for all G0121 claims require only one ICD-9: V76.51 (Special screening for malignant neoplasms; colon). If the chart indicates...

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