Question 1

What is HCPCS code G0104?

Accepted Answer

HCPCS code G0104 is "Ca screen;flexi sigmoidscope". Colorectal cancer screening; flexible sigmoidoscopy

Question 2

What category is G0104 in?

Accepted Answer

G0104 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0104?

Accepted Answer

Use G0104 when billing for ca screen;flexi sigmoidscope. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0104 covered by Medicare?

Accepted Answer

Coverage for G0104 (Ca screen;flexi sigmoidscope) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0104?

Accepted Answer

Documentation for G0104 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).