HCPCS code G0121 — Colon ca scrn not hi rsk ind.
Status: Active.
Effective Jan 1, 2024.
Source: CMS HCPCS Level II.
G0121
ActiveColon ca scrn not hi rsk ind
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Category:
Procedures
Section:
G-codes: Procedures / Professional Services
Effective:
Jan 1, 2024
Code type:
alphanumeric
OPPS Status:
T
— Significant procedure — subject to multiple procedure reduction
OPPS APC:
5311
MUE — Medically Unlikely Edits
Maximum units of G0121 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 G0121 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0105 | Modifier cannot 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
G0121 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0104 | Modifier cannot bypass edit |
| G0327 | Modifier cannot bypass edit |
| G0337 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
Change History
Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.
-
New Code 2024-Q1Colon ca scrn not hi rsk ind