Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

Coverage includes colonoscopy, sigmoidoscopy, or proctosigmoidoscopy for surveillance of colonic neoplasia in patients with a history of colorectal cancer or polyps, and for a high-risk follow-up 1 year after colorectal cancer surgery. For surveillance claims include the appropriate CPT/HCPCS and primary ICD-10-CM code plus one of the specified Z-codes as a secondary diagnosis (Z85.038, Z85.048, Z86.0100, Z86.0101, Z86.0102, Z86.0109); report HCPCS G0105 for the high-risk 1-year follow-up and subsequent 24-month interval screenings.

"Colonoscopy/sigmoidoscopy/proctosigmoidoscopy is covered for surveillance of colonic neoplasia in patients with a history of colorectal cancer or colonic polyps."

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