Summary & Overview
HCPCS M1377: Recommended 10-Year Repeat Colonoscopy Interval
HCPCS Level II code M1377 represents documentation that a patient was advised a 10-year interval for repeat colonoscopy, recorded in the colonoscopy report and communicated to the patient. This code captures a specific administrative and clinical communication step that supports quality reporting and longitudinal care planning in colorectal cancer screening and surveillance programs. Nationally, clear documentation of surveillance intervals influences care coordination, preventive care adherence, and accurate claims reporting.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical context in colorectal cancer screening, typical service settings, and how the code is used for documentation of recommended surveillance intervals. The publication outlines potential benchmarks and coverage considerations where available, highlights relevant policy updates affecting coded documentation practices, and provides practical context for coding teams and health system administrators.
The content is intended to help billing managers, quality officers, and clinicians understand the purpose of HCPCS Level II code M1377, where it fits in surveillance workflows, and what elements of the colonoscopy encounter it represents. Data not available in the input has been noted where applicable.
Billing Code Overview
HCPCS Level II code M1377 documents a recommended follow-up interval for repeat colonoscopy of 10 years when that recommendation is recorded in the colonoscopy report and communicated with the patient. The service reflects documentation and communication of a 10-year surveillance interval after a colonoscopy.
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Service type: Documentation and patient communication of recommended surveillance interval
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Typical site of service: Ambulatory surgical center or outpatient endoscopy suite
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 56-year-old average-risk patient undergoes screening colonoscopy performed in an ambulatory endoscopy center. The colonoscopy is complete, high-quality bowel prep documented, no adenomas are found, and the endoscopist documents a recommended follow-up interval of 10 years in the colonoscopy report and communicates this recommendation to the patient prior to discharge. The procedure note includes indication (screening), findings, quality metrics (cecal intubation, bowel prep quality), and the explicit statement that the next colonoscopy is recommended in 10 years. The endoscopy facility billing staff assigns HCPCS Level II code M1377 to capture the documented recommendation for a 10-year repeat colonoscopy, links the report to the patient’s medical record, and includes appropriate facility and professional claims per standard billing workflow. Typical sites of service are ambulatory surgical centers and hospital outpatient endoscopy units. Typical patient scenarios include average-risk screening with normal exam, surveillance after previous normal exam, or post-polypectomy surveillance when 10-year interval is indicated by guideline-based findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work is substantially greater than typical for the service due to complexity documented in the report. |