Gastroenterology: Screening, Surveillance, or Diagnostic? The Colonoscopy Classification That Can Change the Claim

Section analysis by Oksana Pokoyeva, Billing Department, WCH

Editorial note: This article draws on CPT and CMS guidance on colorectal cancer screening coverage, HCPCS G0105/G0121 coding rules, the Medicare National Coverage Determination and Claims Processing Manual provisions on colorectal cancer screening, ICD-10-CM Official Guidelines for Coding and Reporting, the Removing Barriers to Colorectal Cancer Screening Act coinsurance phase-down schedule, USPSTF recommendation language, and ASGE coding-education commentary, current through September 2026. It is for informational and educational purposes only and does not constitute legal, coding, or compliance advice. Payer-specific requirements should be verified against the current CPT manual, current ICD-10-CM code set, and payer policy before billing.