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Gastroenterology Coding Alert

CPT 2011:
Rejoice -- You've Got New Codes for Colon Motility and Manometric Studies
Don't overlook two revised codes for esophageal pH monitoring. If you've been ... Read more
Clarified:
Modifiers 52, 53 Call It 'Quits' for Incomplete Scope
Suppose your gastroenterologist performs a procedure on a patient who is scheduled and pre... Read more
Diagnosis Coding:
Dysphagia 101: Synch Your Knowledge with CPT and ICD-9 Guidelines
CPT has a lone code to fit most of dysphagia-related treatment. Find out what.If you're of... Read more
Documentation:
Hail to the Chief -- Complaint: Here's What You Might Be Missing
Chief complaint need not be the top note, but physicians must state it clearly.Getting din... Read more
Reader Questions:
Colon Cancer High-Risk Patients Defined
Question: How is a patient considered high risk for developing colorectal cancer?Maine Sub... Read more
Reader Questions:
578.9, 456.20 Are Cirrhosis Diagnosis Options
Question: My gastroenterologist sees a patient for a "cirrhosis likely secondary to... Read more
Reader Questions:
When Is A Colonoscopy Complete?
Question: What would be the appropriate modifier to use when the doctor does reaches the c... Read more
Reader Questions:
Modifier 78 Takes You Back to the OR for a Different Procedure
Question: A Medicare patient returns to the endoscopy lab at 4 p.m. to control a bleeding ... Read more
You Be the Coder:
43201, 43236 Veer Away from Old School Botox Injection Coding
Question: My gastroenterologist performed a Botox injection on a patient with achalasia, a... Read more
Hemoccult Test:
82270, 82272, G0107: Ease Your Hemoccult Test Coding With This Advice
Why, who, and where work hand-in-hand to point you to the right code.If you want to keep t... Read more
Endoscopic Retrograde Cholangiopancreatography:
43262-43269 Is Your Guide to Profitable ERCP Coding
Get paid twice the $440 rate for 43268. Find out how.If you think coding for endoscopic re... Read more
Bleed Control:
43255 Leaves No Stones Unturned for Control-of-Bleeding Situations
Forget about modifier 22 or you'll be stuck in old school.Modifier 22 may not be the ally ... Read more
Reader Questions:
45335 Gets the Distinctive Modifier
Question: If billing the codes 45334 and 45335 together, which one would get the modifier ... Read more
Reader Questions:
43248 and 43239: Don't Overlook Your Upper GI Encoscopy Codes
Question: How should I report an endoscopic procedure based on the following op note? "The... Read more
Reader Questions:
G0105 Screens Your Colorectal Cancer Coding Options
Question: The surgeon prepares a Medicare patient meeting high-risk criteria for a screeni... Read more
Reader Questions:
153.0-153.9 and 154.0-154.8 Are Go-To ICD-9 Codes for Colorectal Cancer
Question: When should I use a diagnosis of colorectal cancer versus a diagnosis of history... Read more
Reader Questions:
Symptoms Apply as Primary Diagnosis for "Bacterial
Question: A patient presents with "bacterial overgrowth -- small intestine.&qu... Read more
Reader Questions:
49659 Best Describes Lap Repair of Hernia in the Intestine
Question: My gastroenterologist performed laparoscopic release and repair of an incarcerat... Read more
You Be the Coder:
ICD-9 154.1 Is Your Rectal Cancer Bet
Question: A non-Medicare patient who was recently diagnosed with rectal cancer underwent a... Read more
Colon Cancer Screening:
G0121 Offers the Best Choice for Coding Colon Cancer Study
Frequency rules vary for average, high risk patients. If you're coding for colorec... Read more
Small Intestine Probe:
91110 and 91111: Partners in Small Intestine Study
Repeat studies demand this modifier.When your gastroenterologist uses capsule study to obt... Read more
Surgical Coding:
46250-46262: Bypass 3 Myths When Coding Int/Ext Hemorrhoidectomy
Unlisted procedure for anus has got more company than what you thinkYou're facing a blank ... Read more
Reader Questions:
+96375 Resolves Benadryl Infusion Dilemma
Question: How should I code this encounter: An established patient with a plan of care in ... Read more
Reader Questions:
43235 and 91035 Work Hand-in-Hand
Question: A gastroenterologist sees a new patient complaining of frequent belching and hea... Read more
Reader Questions:
Here Come the Latest CCI Edits
Question: A coder in my practice is asking me a lot of questions about CCI Edits 16.3. Wha... Read more
Reader Questions:
45305 Bundles Anoscopy and Mucous Membrane Biopsy
Question: My gastroenterologist performed a rigid sigmoidoscopy, along with anoscopy witho... Read more
Reader Questions:
43235- 43259: Location and Treatment Method on Documentation Matters
Question: I'm preparing a documentation checklist for endoscopy. What information should I... Read more
Reader Questions:
Co-existing Med Condition Is a Requirement for Anesthesia Service
Question: When I coded 00810 for anesthesia service during an esophagogastroduodenoscopy (... Read more
Reader Questions:
G0121 Accepts No Other ICD-9 But V76.51
Question: A 73-year-old established Medicare patient with average risk for colorectal... Read more
You Be the Coder:
45378 In Place of an E/M Code
Question: A patient, referred by his physician, presents to our office for a diagnostic co... Read more
Mythbuster:
Bust 3 Myths for Simplified GERD Dx Test Coding
Find out why modifiers are out of the question for 91034.Whether your gastroenterologist r... Read more
Surgical Coding Quiz:
Optimize Your Code Selection for Enterostomy Closure
Ask the right questions, and you shall have the answers.Do you want a headache-free search... Read more
News Update:
Dodge Claims Rejection by Becoming PECOS-Certified
Medicare postpones July 6 implementation and works to streamline enrollment process.You do... Read more
Enterestomy Closure Solutions:
Count Location and Time as Closure Coding Prerequisites
Your surgeon's op report plays crucial role.When a physician closes a colostomy, resection... Read more
Reader Questions:
Stick with Modifier 59 for Colonoscopy + Polypectomy
Question: What modifier should I use when a gastroenterologist performs colonoscopy, and d... Read more
Reader Questions:
Dysphagia Coding Woes? We've Got the Answer
Question: How should I code the treatment procedure for difficulty in swallowing (dyspha... Read more
Reader Questions:
Report 99080 at Your Own Risk
Question: I did some paperwork for a patient in my practice. Can I bill for it?Tennessee S... Read more
Reader Questions:
Deal with Foreign Body Removal Based on Documentation
Question: A surgeon worked on a patient to repair a reducible umbilical hernia. During the... Read more
You Be the Coder:
Reserve Stage-IV Ulcer Codes for Worst Cases
Question: I'm looking for the right ICD-9 code that specifically describes pressure ulcer.... Read more
Tube Placement:
Get on the Fast Track to Tube Changes Claim Success by Zeroing in These Key Terms
Find out what codes include fluoroscopic guidance.When your gastroenterologist deals with ... Read more
Colonoscopy:
Fit Your Colonoscopy Exam Coding According to Diagnosis
G-codes are handy if the screening doesn't turn diagnostic. You know the deal: If ... Read more
Modifiers:
Examine the Circumstance Before Using Modifier 52, 53
Anesthesia plays a role, too!When your gastroenterologist ends a procedure early, it autom... Read more
Reader Questions:
Put Colonoscopy Dx in the Right Order
Question:A patient comes in for screening colonoscopy that turns therapeutic. Could you cl... Read more
Reader Questions:
Mark Off Similar Proctosigmoidoscopy Codes
Question:A patient underwent formalin chemical fulguration of rectal mucosa with rigid sig... Read more
Reader Questions:
Exchange Feeding Tubes, and Get Paid with 44372
Question:I need help with the CPT for the removal and replacement of a clogged transgastri... Read more
Reader Questions:
Billing Photo Documentation? Not So Fast
Question:My provider is billing an EGD. He states in his op report he states that he obtai... Read more
Reader Questions:
Screening of Diagnostic? Choose the Appropriate FOBT
Question:The gastroenterologist in my practice orders fecal occult blood test (FOBT) for a... Read more
You Be the Coder:
Prepare To Report 43247 When Peeking Into Upper GI Tract
Question:I'm not sure if the physician did an esophagogastroduodenoscopy (EGD) by removing... Read more
Lower Endoscopy Coding:
Reporting Lower GI Scope? Wait Till You Get the Big Picture
Highlighting how far the scope goes could be your clue.Colonoscopy is not the only lower e... Read more
Diagnosis Coding:
3 Tips Clear Up Your Dysphagia Coding Woes
Make sure you specify type. Diagnosing dysphagia is often not cause for alarm among ga... Read more
Modifiers:
Follow 5 Steps for Modifier 22 Claim Success
Your documentation determines the 'unusuality' of the situation.Payoff: The Medicare rate ... Read more
Reader Questions:
Look To 99211 for New-Med Regimen Encounters
Question: The gastroenterologist sees an established patient with a plan of care in place ... Read more
Reader Questions:
Give pH Monitoring a New Treatment
Question: I can't find a CPT that takes into account the prolonged nature of a seven-hour ... Read more
Reader Questions:
Report External Hemorrhoid Removal with 3 Options
Question: I heard gastroenterologists sometimes treat external hemorrhoids, aside from tre... Read more
Reader Questions:
Make Sure 3 Conditions Fit For 91065
Question: My gastroenterologist performs a hydrogen breath test for fructose intolerance. ... Read more
You Be the Coder:
Get Your Tube Fix Claim Right Using Descriptor as Key
Question: Our gastroenterologist treats a patient whose gastrojejunostomy tube has migrate... Read more
ICD- 9 2011 UPDATE:
Prepare to Get Specific With New Fecal Incontinence Codes for 2011
Personal history, fecal impaction codes round out list of gastroenterology diagnosis chang... Read more
Foreign Body Removal:
Don't Get Stuck With Denials When Coding For Foreign Body Removals
Removing or moving foreign body -- the answer will lead you to two different codes.De... Read more
E/M Primer:
Scope Out Potential Level 4 and 5 E/Ms By Knowing Crucial HPI Facts
Watch out for CPT/Medicare differences when counting HPI elements.If you're not accurately... Read more
Clip and Save:
Capture HPI Elements Using These Questions
Get your gastroenterologist to capture the information you need with this handy list.When ... Read more
Reader Questions:
Follow the 3-Year Rule
Question: My gastroenterologist met with a patient in the office at the patient's request ... Read more
Reader Questions:
Bill All Scopes if No Parent
Question: The gastroenterologist performs a biopsy with sigmoidoscopy followed by an endos... Read more
Reader Questions:
ED Visit + Critical Care? Report Only 99291
Question: A patient with abdominal pain presents to the ED, where the on-call gastroentero... Read more
Reader Questions:
Skip Code for Biopsy-Caused Bleeding
Question: The gastroenterologist injected epinephrine into a duodenal ulcer to control act... Read more
Reader Questions:
Achalasia Requires Unique Code
Question: My gastroenterologist used an esophageal dilation to treat achalasia (530.0) by ... Read more
Reader Questions:
Get to the Bottom of Ascites Codes
Question: A 52-year-old female presented with worsening abdominal distension and a 15-poun... Read more
Reader Questions:
Review G-Tube Replacement Procedure Before Choosing 43760
Question: The gastroenterologist treated a nursing home patient in the emergency departm... Read more
You Be the Coder:
Get To Know Most Frequent Multiscope Code
Question: The gastroenterologist treats a patient for bleeding gastric ulcers and also tak... Read more
Pill Cam Procedure Coding:
Visualize Easy PillCam Coding with 3 Expert Tips
Choose 91110 vs. 91111 based on the view.If your gastroenterologist uses a capsule study t... Read more
Quick Quiz:
How Much Do You Know About Consultation Codes?
Be aware of cms /cpt guideline differences to avoid denials.When your gastroenterologist p... Read more
Answer 1:
Check With Your MAC for Guidance
When your gastroenterologist sees a Medicare inpatient and would have used an inpatient co... Read more
Reader Questions:
For Complete ROS, Check at Least 10 Systems
Question: A new patient reports to the gastroenterologist with heartburn, stomach ache, an... Read more
Reader Questions:
Use Modifier 78 for Return to OR
Question: The gastroenterologist cauterizes three internal hemorrhoids with a heater probe... Read more
Reader Questions:
Tackle ERCP + Spincterotomy With Codes
Question: My gastroenterologist performed a pancreatic stent placement during an ERCP with... Read more
Reader Questions:
Be Confident in Coding for Teaching Physicians
Question: A resident in our office sees a new patient complaining of heartburn. The reside... Read more
Reader Questions:
Avoid Confusion when Coding EGDs with EUS
Question: A patient with a gastric ulcerating mass came in for an esophagogastroduodenosco... Read more
You Be the Coder:
Hydration Codes Bundled with Remicade Infusion
Question: A patient came in to our office for a Remicade infusion to treat her Crohn's dis... Read more
CCI 16.1 Update:
Watch Out for New Hemorrhoidectomy, Fluoroscopy Coding Hurdles
The upside is that you'll be able to break some bundles with modifier 59. Just as you're ... Read more
Check the Modifier Indicator Before Overriding CCI Edits
Key: Make sure your documentation will stand up to scrutiny before appending 59. In certa... Read more
Case Study:
Tackle PEG Tube Co-Surgeon Challenges Using Modifier 62
Don't fall into the trap of always using modifier 80. When your gastroenterologist works ... Read more
62 vs. 80
Modifier 62 (Two surgeons): You should look to modifier 62 when your gastroenterologist ... Read more
Don't Become Ensnared in Polyp-Removal Codes
Choose the right code by pinning down the removal method. If you don't correctly code you... Read more
Reader Questions:
Consider Base Code Included in 45334
Question: My gastroenterologist performed a diagnostic sigmoidoscopy (45330), followed by... Read more
Reader Questions:
Use 53 for Procedure Halted for Health Reasons
Question: The gastroenterologist performed a diagnostic upper gastrointestinal endoscopy ... Read more
Reader Questions:
Use ED Codes With Confidence
Question: A patient with acute gastroenteritis comes to the emergency department (ED). Th... Read more
Reader Questions:
Append Modifier 25 to Differentiate E/M Services
Question: The gastroenterologist saw a new patient with rectal bleeding. She provided an ... Read more
Reader Questions:
Link Initial, Subsequent Procedures with Modifier 78
Question: A patient has hemorrhoids and my gastroenterologist cauterizes three internal h... Read more
Reader Questions:
Face Time Is Essential to Established Patient
Question: Our practice performed a test on a patient who was referred to us by another do... Read more
You Be the Coder:
Sometimes You May Need a Separate E/M Code
Question: My gastroenterologist treated a nursing home patient in the emergency departmen... Read more
Medicare Knowledge Can Help You Reap Full NPP Benefits
Plan of care is a must for incident-to- billing. Gastroenterology practices that don't ta... Read more
Safely Pick Between EGD and Enterosocpy Codes Using Key Documentation
Medical necessity should be the governing factor -- not depth or scope type If yo... Read more
Key Guideline Ensures Accurate GI Scope Every Time
Find out CPT, Medicare, private payers' take on 43239 and 43248 claims.If you confuse comp... Read more
Be Aware of Medicare Screening Requirements Or Rick Payment Denial
Following 10-year-rule eliminates G0121 rejection.If you slip up on screening colonoscopy ... Read more
Reader Question:
Append Modifier 78 for Unplanned Return to OR
Question: My gastroenterologist placed a gastrostomy tube. Then, the tube leaked eight day... Read more
Reader Question:
Designate Separate E/M with 25
Question: During a meeting with a patient complaining of heartburn, my gastroenterologist ... Read more
Reader Question:
Support In-Office FOBT Services With Dx
Question: A 68-year-old established patient reports to the gastroenterologist complaining ... Read more
Reader Question:
List Definitive Reflux Dx When Doc Gives Details
Question: An established patient presented with difficulty swallowing. My gastroenterologi... Read more
Reader Question:
Employ 59 for Stents Placed in Multiple Ducts
Question: If my physician places stents in both the pancreatic and bile ducts, do I only b... Read more
Reader Question:
Maximize E/M Service Payments for Hepatitis Patients
Question: My gastroenterologist recently saw a patient at the request of the primary-care ... Read more
You Be The Coder:
Reason for Admission Determines Code
Question: A patient with Crohn's disease was admitted to the hospital for a gastrointestin... Read more
Follow This Lower GI Guide for Help Navigating Endoscopies
A single centimeter can change code choice for these procedures. Confused about those ope... Read more
Use This FAQ to Get on the Level With Your ROS Coding
Remember, ROS errors can ruin E/M level assignment. A lack of E/M coding smarts can cost ... Read more
Use This List for ROS Success
Also, check if your payer uses Medicare ROS rules. Coders have to count systems constantl... Read more
READER QUESTIONS:
Check LCD When Considering High-Risk Dx
Question: A 65-year-old established Medicare patient with regional enteritis and a family... Read more
READER QUESTIONS:
Combine G Code With Dx for Requested DRE
Question: I had a Medicare beneficiary ask for a prostate exam. Our doctor dictated the e... Read more
READER QUESTIONS:
Ensure Counseling Claims With Pointed Questions
Question: Can I report alcohol cessation counseling codes along with E/M codes, or do I h... Read more
READER QUESTIONS:
Go Straight to Source for CC Info
Question: A patient comes into the gastroenterologist with complaints of upper GI pain, u... Read more
READER QUESTIONS:
Remember These Rules for Patient-Supplied Injections
Question: A patient receives office injections for vitamin B12. She supplies the medicine... Read more
You Be the Coder :
Visibility Matters On Hematuria ICD-9
Question: Encounter notes state that a new patient reported to the gastroenterologist com... Read more
Here's How to Code Fearlessly for FOBT Servicess
Proper patient participation a must for 82270. Coding for your gastroenterologist's fecal... Read more
Dig Into This Critical Care FAQ to Avoid Leaving $45 on the Table
Do your physicians know what's bundled into 99291? Your gastroenterologist reports to a l... Read more
Steer Clear of This Continuous Time Trap
Check out this advice on 'split' CC visits. When a gastroenterologist leaves a critically... Read more
News You Can Use:
Coming Your Way Soon: Pre-Pay Edits for Nursing Facility E/Ms?
Check out this advice on 'split' CC visits. If you think CMS is only watching your E/M co... Read more
Clarification:
Clarification:
The Reader Question "Observe Bundles for ERCP Code," in Vol. 11, No. 11 of Gastroenterolo... Read more
READER QUESTIONS:
Select 99211 for Most Med Checks
Question: An established patient with a plan of care in place for her gastroesophageal re... Read more
READER QUESTIONS:
Scheduling Sessions Squelches Most E/Ms
Question: Our gastroenterology practice recently opened an infusion suite on site --... Read more
READER QUESTIONS:
Counseling Must Dominate Exception Claims
Question: A new patient with a chronic gastric ulcer meets the gastroenterologist for man... Read more
READER QUESTIONS:
Use Physician Notes to Narrow Crohn's Choice
Question: A new Medicare patient reports to the gastroenterologist with complaints of dia... Read more
You Be the Coder:
Bundles Abound for 45331 Code
Question: The gastroenterologist performs expanded problem focused interval history and e... Read more