How To Use HCPCS Code G0122

HCPCS code G0122 describes a specific procedure used for colorectal cancer screening known as a barium enema. This code is used to identify and bill for the services provided during this screening process. In this article, we will explore the details of HCPCS code G0122, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0122?

HCPCS code G0122 is a specific code used to identify and bill for colorectal cancer screening using a barium enema. This procedure involves the use of a contrast material called barium, which is inserted into the rectum and colon through a tube. The barium coats the lining of the colon and rectum, allowing for better visualization during an X-ray examination. This screening method helps detect abnormalities or signs of colorectal cancer.

2. Official Description

The official description of HCPCS code G0122 is “Colorectal cancer screening; barium enema.” The short description is “Colon ca scrn; barium enema.” These descriptions accurately summarize the purpose and nature of the procedure.

3. Procedure

1. The patient is positioned on an X-ray table, usually lying on their side.
2. A lubricated tube is gently inserted into the rectum.
3. A contrast material, such as barium, is slowly injected through the tube into the colon.
4. X-ray images are taken while the patient changes positions to ensure thorough visualization of the entire colon.
5. The barium is then expelled from the colon, and the procedure is complete.

4. When to use HCPCS code G0122

HCPCS code G0122 should be used when performing a barium enema for colorectal cancer screening purposes. It is important to follow the specific guidelines and eligibility criteria set by the healthcare provider or insurance company to ensure proper use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0122, healthcare providers need to document the details of the procedure, including the patient’s medical history, the reason for the screening, and any relevant findings or observations. It is crucial to include the appropriate diagnosis codes to support the medical necessity of the screening. Proper documentation and accurate coding are essential for successful reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0122 was added to the Healthcare Common Procedure Coding System on January 01, 1998. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code G0122 is classified as non-covered by Medicare, as indicated by the coverage code M. This means that Medicare does not provide reimbursement for this specific procedure. It is important to check with other insurance providers to determine their coverage policies for HCPCS code G0122.

8. Examples

Here are five examples of when HCPCS code G0122 should be billed:

1. A 50-year-old patient with a family history of colorectal cancer undergoes a barium enema screening as part of their routine preventive care.
2. A patient presents with symptoms such as rectal bleeding and abdominal pain, prompting the need for a barium enema to investigate potential colorectal issues.
3. A follow-up screening is performed for a patient who previously had a polyp removed during a colonoscopy.
4. A patient with a history of inflammatory bowel disease requires regular screenings to monitor for any signs of colorectal cancer.
5. A patient who is unable to undergo a colonoscopy due to medical reasons opts for a barium enema as an alternative screening method.