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])
Short DescriptionDoc med rsn <3 colon
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2024
Code Added DateJanuary 01, 2022
Pricing Indicator00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)
Type of Service1 = Medical care