Summary & Overview
HCPCS G9935: Screening Colonoscopy, No Adenoma or Colorectal Cancer Detected
HCPCS Level II code G9935 denotes a screening colonoscopy in which adenoma(s) or colorectal cancer were not detected. This code captures a common preventive procedure that supports colorectal cancer screening metrics and quality reporting. Nationally, documenting negative screening results is important for accurate preventive care measurement, population health tracking, and appropriate screening interval planning.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies for screening colonoscopy can affect use of administrative codes like G9935 for tracking negative findings, informing quality programs and payer reporting requirements.
Readers will learn the clinical context of the code, typical sites of service, and what documentation this code reflects. The publication provides benchmarks and policy-relevant context for national payer coverage practices, coding guidance for negative screening findings, and implications for preventive care reporting. Data not available in the input is noted where relevant.
Billing Code Overview
HCPCS Level II code G9935 indicates that adenoma(s) or colorectal cancer were not detected during a screening colonoscopy. The service type is screening colonoscopy with negative findings for adenomas or colorectal cancer, representing preventive colorectal cancer screening procedures. The typical site of service is an endoscopy suite or outpatient ambulatory surgical center, where screening colonoscopies are commonly performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old average-risk patient presents for a screening colonoscopy. The procedure is performed under moderate sedation in an ambulatory endoscopy center. The endoscopist advances the colonoscope to the cecum, carefully inspects the mucosa, and documents no adenomas or colorectal cancer. Biopsies are not performed because no lesions are identified. The patient is monitored in recovery and discharged with routine post-procedure instructions.
This service is coded when a screening colonoscopy yields no adenomatous polyps or malignancy identified during the exam. Typical workflow includes pre-procedure evaluation, informed consent, colonoscopic examination with photographic documentation of cecal landmarks, procedure note stating no polyps or cancer found, recovery, and generation of an operative report and screening result communication to the referring provider and payor.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity exceeds that typically required for the screening colonoscopy without polyps (e.g., extensive adhesiolysis or prolonged procedure time). |
23 | Unusual anesthesia |