HCPCS code G0105 — Colorectal scrn; hi risk ind.
Status: Active.
Effective Jan 1, 1998.
Source: CMS HCPCS Level II.
G0105
ActiveColorectal scrn; hi risk ind
Colorectal cancer screening; colonoscopy on individual at high risk
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 1998
Code type:
alphanumeric
OPPS Status:
T
— Significant procedure — subject to multiple procedure reduction
OPPS APC:
5311
MUE — Medically Unlikely Edits
Maximum units of G0105 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with G0105 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0181 | Modifier may bypass edit |
| G0182 | Modifier may bypass edit |
| G0380 | Modifier may bypass edit |
| G0381 | Modifier may bypass edit |
| G0382 | Modifier may bypass edit |
| G0383 | Modifier may bypass edit |
| G0384 | Modifier may bypass edit |
| G0463 | Modifier may bypass edit |
| G0471 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
NCCI Edits — Reverse Direction
G0105 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0104 | Modifier cannot bypass edit |
| G0121 | Modifier cannot bypass edit |
| G0327 | Modifier cannot bypass edit |
| G0337 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)