US · guidance
CMS Pub. 100-02, ch. 15, § 280.2.5
Noncovered Services
B3-4180.5
The following noncovered HCPCS codes are used to allow claims to be billed and denied
for beneficiaries who need a Medicare denial for other insurance purposes for the dates of
service indicated:
A. From January 1, 1998 Through June 30, 2001, Inclusive
Code G0121 (colorectal cancer screening; colonoscopy on an individual not meeting
criteria for high risk) should be used when this procedure is performed on a beneficiary
who does NOT meet the criteria for high risk. This service should be denied as
noncovered because it fails to meet the requirements of the benefit for these dates of
service. The beneficiary is liable for payment. Note that this code is a covered service for
dates of service on or after July 1, 2001.
B. On or After January 1, 1998
Code G0122 (colorectal cancer screening; barium enema) should be used when a
screening barium enema is performed NOT as an alternative to either a screening
colonoscopy (code G0105) or a screening flexible sigmoidoscopy (code G0104). This
service should be denied as noncovered because it fails to meet the requirements of the
benefit. The beneficiary is liable for payment.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7217ddd0f0bfbee537e72a33244f41f3411966695474146e1fa06e4831baed41
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