Tuesday 11 September 2012

PT codes - Sigmoidoscopy Colonoscopy Service Codes


Colon Cancer Screening - Provider Billing Guidelines and Documentation


Fecal Occult Blood Test Service Codes

Code            Description
82270     Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)

82272    Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening

G0328     COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS DETERMINATIONS



Barium Enema Service Codes


Code                   Description

74270       Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB
74280       Radiologic examination, colon; air contrast with specific high density barium, with or without                                          
                  lucagon
G0122       COLORECTAL CANCER SCREENING; BARIUM ENEMA



Sigmoidoscopy Service Codes

Code                           Description

45330              Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or 
                        washing (separate procedure)  
45331              Sigmoidoscopy, flexible; with biopsy, single or multiple
45332              Sigmoidoscopy, flexible; with removal of foreign body
45333              Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy 
                         forceps or bipolar cautery
45334              Sigmoidoscopy, flexible; with control of bleeding (eg, injection, bipolar cautery, unipolar 
                         cautery, laser, heater probe, stapler, plasma coagulator)
45335               Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance
45337               Sigmoidoscopy, flexible; with decompression of volvulus, any method
45338               Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare 
                         technique
45339               Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable 
                          to removal by hot biopsy forceps, bipolar cautery or snare technique
45340               Sigmoidoscopy, flexible; with dilation by balloon, 1 or more strictures
G0104              COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY
G0106              COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0104, SCREENING 
                           SIGMOIDOSCOPY, BARIUM ENEMA.


Colonoscopy Service Codes

Code                       Description

44388                     Colonoscopy through stoma; diagnostic, with or without collection of specimen(s) by 
                                brushing or washing (separate procedure)
44389                     Colonoscopy through stoma; with biopsy, single or multiple
44390                     Colonoscopy through stoma; with removal of foreign body
44391                     Colonoscopy through stoma; with control of bleeding (eg, injection, bipolar cautery, 
                               unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44392                     Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by 
                                hot biopsy forceps and bipolar cautery
44393                     Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not 
                                amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
44394                     Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by 
                                snare technique
45355                    Colonoscopy, rigid or flexible, transabdominal via colostomy, single or multiple
45378                    Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection                                                                                                 
               of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) 
45379                    Colonoscopy, flexible, proximal to splenic flexure; with removal of foreign body
45380                    Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
45381                    Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), 
                                any substance
45382      Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar             
                cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
45383       Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or 
                  other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare 
                   technique. 
45384       Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other 
                   lesion(s) by hot biopsy forceps or bipolar cautery
45385         Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or 
                    other lesion(s) by snare technique
45387        Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement 
                     (includes predilation)
G0105        Colorectal Cancer Screening; Colonoscopy on individual at high risk
G0120         Colorectal Cancer Screening; alternative to G0105, screening colonoscopy, barium enema
G0121         Colorectal Cancer Screening; Colonoscopy on individual not meeting criteria for high risk. 

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