2015-10-21 11:51:52 UTC

AGA Meets with CMS Regarding ICD-10 Issue

Oct. 21, 2015

AGA will continue to work with CMS until a solution is implemented.

Late last week, AGA received reports that some Medicare contractors are rejecting a specific colonoscopy screening code: G0105 with Z86.010. On Monday, AGA, ASGE and ACG met with Sean Cavanaugh, the deputy administrator and director of CMS, and alerted him to this issue.  

The affected code is G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) when submitted with ICD-10 code Z86.010 (Personal history of colonic polyps). The problem has impacted beneficiaries in the following Medicare Administrative Contractors (MACs): National Government Services Inc., Novitas Solutions Inc., Noridian Healthcare Solutions, LLC, Palmetto GBA, and First Coast Service Options, Inc. 

We have also contacted the CMS Ombudsman, which is investigating the matter. We will continue to work with CMS until a solution is implemented.

Have you received denials for G0105 with Z86.010? Are you experiencing other ICD-10 implementation issues? Please contact Leslie Narramore, director of reimbursement, AGA Institute. 

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