G0122 Barium Enema Reimbursement & Policy

HCPCS Level II code G0122 designates colorectal cancer screening performed with a barium enema, a radiologic contrast examination of the colon. Though less commonly used than endoscopic methods, barium enema remains a recognized screening modality and is relevant for programs and payers that maintain coverage policies for alternative screening options. Nationally, the code is relevant for preventive services, quality measurement, and billing consistency across outpatient imaging settings.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthCare, and Medicare. Readers will find an overview of how G0122 is classified and billed, where the service is typically performed, and what to expect in payer coverage frameworks. The publication summarizes benchmark considerations, coding context, and any recent policy updates affecting radiologic screening options where available.

This summary serves clinicians, billing professionals, and policy analysts seeking a concise reference on the clinical purpose and payer relevance of HCPCS Level II code G0122. Specific coding scenarios, modifier guidance, and diagnosis pairings are addressed in subsequent sections. If detailed payer-specific coverage rules are required, consult individual payer policy documents.

Billing Code Overview

HCPCS Level II code G0122 represents colorectal cancer screening using a barium enema. The service is a radiologic contrast study of the colon intended for colorectal cancer screening when colonoscopy or other screening modalities are not used.

Service type: Barium enema colorectal cancer screening
Typical site of service: Outpatient radiology suite, hospital outpatient department, or ambulatory imaging center

Data not available in the input.

Clinical Context

A 62-year-old average-risk adult presents to outpatient radiology for a colorectal cancer screening using a barium enema (G0122) because the patient declines or is unable to undergo colonoscopy and no recent fecal immunochemical test is available. The primary care clinician orders the exam after a preventive visit; the radiology scheduling team confirms bowel preparation instructions. On the day of service the patient checks in at the radiology department (typical site of service: outpatient radiology/ambulatory imaging center). The technologist and radiologist review history for contraindications, perform the barium enema fluoroscopic exam, obtain spot images and a radiologist interpretation, and document findings in the imaging report. If an abnormality is identified (mass, filling defect, or significant polyp suspicion), the radiologist communicates results to the referring clinician for endoscopic correlation and possible diagnostic colonoscopy. Billing uses G0122 for the screening barium enema performed as the colorectal cancer screening modality; appropriate ICD-10 diagnosis codes are appended to indicate screening or specific clinical signs when applicable.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the radiologist's reading/interpretation separate from the technical component.

Taxonomy Code	Specialty	Notes
`2080P0206X`	Radiology (Diagnostic Radiology)	Radiologists interpret fluoroscopic barium enema studies and issue final reports.
`2085R0201X`	Gastroenterology	Referring gastroenterologists evaluate screening findings and coordinate diagnostic colonoscopy if needed.
`207K00000X`	Family Medicine	Primary care clinicians order screening tests and coordinate preventive care.
`261QM0800X`	Hospitalist/Internal Medicine	Internists may order and follow up on screening imaging in ambulatory settings.
`363L00000X`	Radiologic Technologist	Performs fluoroscopic study and image acquisition under radiologist supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z12.11`	Encounter for screening for malignant neoplasm of colon	Primary screening indication for `G0122` when performed as colorectal cancer screening.
`R19.4`	Change in bowel habit	Symptom that may prompt imaging evaluation if screening or diagnostic concerns arise.
`K59.1`	Functional diarrhea	Symptom differential; not a direct indication for screening but may be part of clinical history reviewed before barium enema.
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	May be part of clinical evaluation when imaging is considered for abdominal complaints.
`D12.6`	Benign neoplasm of colon, unspecified	Finding that may be suspected or clarified on barium enema and require endoscopic correlation.
`C18.9`	Malignant neoplasm of colon, unspecified	Suspicion of malignancy could lead to diagnostic imaging and follow-up procedures after abnormal screening.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`74270`	Radiological examination, colon; contrast, barium enema, single contrast, including imaging and fluoroscopic supervision and interpretation	Directly analogous CPT code describing a barium enema study; often used in non-HCPCS contexts for reimbursement and clinical documentation.
`74280`	Radiological examination, colon; contrast, barium enema, double contrast, including imaging and fluoroscopic supervision and interpretation	Alternative barium enema technique that may be performed when double-contrast technique is indicated.
`45378`	Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Used when an abnormality on barium enema prompts diagnostic colonoscopy; documents endoscopic evaluation.
`88305`	Level IV pathology, surgical pathology, gross and microscopic examination	Used when biopsy or polypectomy from follow-up colonoscopy yields specimens requiring pathology.
`G0105`	Colorectal cancer screening; colonoscopy on individual at high risk	Screening colonoscopy HCPCS code referenced when colonoscopy, rather than barium enema, is the chosen screening modality.

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Summary & Overview

HCPCS G0122: Colorectal Cancer Screening, Barium Enema