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 Description | Doc med rsn <3 colon |
|---|---|
| Year | 2026 |
| Coverage Code | C = Carrier judgment |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2024 |
| Code Added Date | January 01, 2022 |
| Pricing Indicator | 00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.) |
| Type of Service | 1 = Medical care |