2024 HCPCS Code G9998

Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])

TAGS: lower greater inadequate colonoscopy history patient since cancer personal serrated interval piecemeal underlying colon documentation hereditary years removal sessile medical polyps family colorectal gastrointestinal ulcerative found

Short DescriptionDoc med rsn <3 colon
HCPCS Coverage Code C - Carrier judgment
HCPCS Action Code N - No maintenance for this code
HCPCS Action Effective Date January 01, 2024
HCPCS Code Added Date January 01, 2022
HCPCS Pricing Indicator Code 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code 1 - Medical care
HCPCS Anesthesia Base Unit Quantity 0

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