What is the difference between 45378 and 45380?
A family of CPT codes applies to colonoscopy. For example, code 45378 applies to a colonoscopy in which no polyp is detected, while codes 45380-45385 apply to colonoscopy that involves an intervention (e.g., 45385 is the code for colonoscopy with polypectomy.)
What is the difference between G0105 and G0121?
For Medicare beneficiaries, use Healthcare Common Procedural Coding System (HCPCS) code G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) or G0121 (Colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk) as appropriate.
What is procedure code 45378?
COLONOSCOPY, FLEXIBLE
Group 1
| Code | Description |
|---|---|
| 45378 | COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE) |
| 45379 | COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S) |
| 45380 | COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE |
What is procedure code G0121?
colorectal cancer screening
G0121, colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk. Z12. 11, encounter for screening for malignant neoplasm of colon.
Can CPT code 45378 and 45380 be billed together?
The physician bills for codes 45380 and 45385. The value of codes 45380 and 45385 have the value of the diagnostic colonoscopy (45378) built in. When multiple procedures are performed at the same session by the same individual, the primary procedure or service may be reported as listed.
Does CPT code 45380 need a modifier?
The NCCI PTP edit with column one CPT code 45385 (Flexible colonoscopy with removal of tumor(s), polyp(s), or lesion(s) by snare technique) and column two CPT code 45380 (Flexible colonoscopy with single or multiple biopsies) is often bypassed by using modifier 59 or -X{EPSU}.
What is procedure code 99152?
The Current Procedural Terminology (CPT®) code 99152 as maintained by American Medical Association, is a medical procedural code under the range – Moderate (Conscious) Sedation.
What is procedure code 45384?
45384. COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS. 45385. COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE.
What is CPT code G0328?
HCPCS code G0328 Colorectal cancer screening; fecal-occult blood test (alternative to CPT code 82270)
Can CPT code 45380 and 45385 be billed together?
Based on CPT Assistant article: “From a CPT coding perspective, if the same lesion is biopsied, and subsequently removed during the same operative session, then you should only report the code for the removal of the lesion.” Therefore, if 45380 is submitted with 45385–only 45385 reimburses.