G0105 code

If a Medicare patient comes in for a screening colonoscopy and the doctor finds diverticulitis is it proper to bill G0105 with V1270. My boss says you only bill the G0105 with a personal or family history of colon cancer. Please help. Thanks, Beth

re: G0105 CODE

You would bill G0105 if the patient was at high risk (personal/family history of polyps or cancer). If it was purely for screening purposes you would bill G0121 with 562.11 and V76.51.

re: G0105 CODE

You should code for the screening as primary and the others as secondary and additional diagnosis. The reason for the encounter was screening.

re: G0105 CODE

That is correct. I guess I didn't pay attention to what order I put the diagnoses in.

re: G0105 CODE

So I should use G0121 with V76.51 and history of diverticulits 562.11 as a secondary diagnosis for this Medicare claim?

re: G0105 CODE

Yes, if the patient had a screening colonoscopy and only diverticulitis was found, you would bill G0121 with V76.51 & 562.11