Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy

Medicare considers a colonoscopy attempt that cannot be completed due to extenuating/unforeseen circumstances (e.g., inability to advance to the cecum or colon–small intestine anastomosis) an incomplete/failed colonoscopy. Failed attempts must be billed with CPT 45378, HCPCS G0105/G0121, or CPT 44388 (if via stoma) and must include modifier -53; when a colonoscopy is subsequently completed Medicare will pay for the completed procedure if usual coverage conditions are met. This applies to both screening and diagnostic colonoscopies.

"A colonoscopy attempt that cannot be completed because of extenuating/unforeseen circumstances (e."

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