Question 1

What is HCPCS code G0105?

Accepted Answer

HCPCS code G0105 is "Colorectal scrn; hi risk ind". Colorectal cancer screening; colonoscopy on individual at high risk

Question 2

What category is G0105 in?

Accepted Answer

G0105 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0105?

Accepted Answer

Use G0105 when billing for colorectal scrn; hi risk ind. 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

What ICD-10 codes are commonly used with G0105?

Accepted Answer

Common ICD-10 diagnosis codes used with G0105 include: A03.9 (Shigellosis, unspecified), A04.3 (Enterohemorrhagic Escherichia coli infection), A04.5 (Campylobacter enteritis), A04.6 (Enteritis due to Yersinia enterocolitica). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is G0105 covered by Medicare?

Accepted Answer

Coverage for G0105 (Colorectal scrn; hi risk ind) 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 6

What documentation is required for G0105?

Accepted Answer

Documentation for G0105 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).