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CPT G0106, G0120, G0122 Barium enema as a colorectal cancer screening modalityLast reviewed at VbBS in November 2017. Minutes indicate that the staff recommendation was accepted without significant discussion. HERC approved the recommendations without change. Issue: The VBBS approved the placement of 3 HCPCS codes for barium enema for screening for colorectal cancer during the review of the coverage guidance on colorectal cancer screening modalities in September, 2017. HERC has returned these 3 codes to the VBBS for reconsideration for placement. Barium enema is a diagnostic test that is useful in certain clinical situations, but is not a test used for colorectal cancer screening and was not reviewed in the coverage guidance on CRC screening. The barium enema CRC screening HCPCS codes are currently in the Ancillary File. The following codes are diagnostic and should remain so:CPT 74270 Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB CPT 74280 Radiologic examination, colon; air contrast with specific high density barium, with or without glucagonThe following code is ancillaryCPT 74283 Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)HERC Staff Recommendations: Add CPT 74283 (Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)) to line 41 INTUSSCEPTION, VOLVULUS, INTESTINAL OBSTRUCTION, HAZARDOUS FOREIGN BODY IN GI TRACT WITH RISK OF PERFORATION OR OBSTRUCTION Intussusception and intestinal obstruction are both on line 41. Advise HSD to remove CPT 74283 from the Ancillary ListOption 1: Add the following HCPCS codes to line 500 CONDITIONS FOR WHICH CERTAIN INTERVENTIONS RESULT IN MARGINAL CLINICAL BENEFIT OR LOW COST-EFFECTIVENESS and add an entry to GN172 as shown belowG0106 (Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema)G0120 (Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema)G0122 (Colorectal cancer screening; barium enema)There has been no evidence review of barium enema for CRC screening; therefore it is not known if it is an unproven treatment. However, this test is no longer used for CRC screening nor mentioned in the USPSTF recommendations for CRC screening. Other, more evidence-based and effective screening tools exist. GUIDELINE NOTE 172, INTERVENTIONS WITH MARGINAL CLINICAL BENEFIT OR LOW COST-EFFECTIVENESS FOR CERTAIN CONDITIONSThe following interventions are prioritized on Line 500 for the conditions listed here:CPT/HCPCS codeINTERVENTIONRationaleDate of Last Review/Link to Meeting MinutesG0106, G0120, G0122Barium enema as a colorectal cancer screening modalityNo longer used as a CRC screening modalityNovember, 2017 ................
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