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Gastroenterology Coding Alert

CPT® 2014 Update:
Beef Up Your E/M Code Lists With New Interprofessional Codes in 2014
Hint: Add up time when discussion spans over more than one session. When your gastroen... Read more
Physician Signatures:
Get Up-to-date With Signature Rules and Exceptions Using These 3 Tips
Analyze CMS’s requirements or you risk the wrong use of signatures. If you fear ... Read more
ICD-10 Update:
Add More Options,Better Specificity For Diverticulosis Reporting
Hint: Hemorrhage and anatomical location still play a role in code selection. When you... Read more
Reader Question:
Avoid Coding Confusion When Reporting Multiple Stent Removals/ Placements
Question: Can I report 43269 twice if our gastroenterologist changed one stent in the bi... Read more
Reader Question:
Planning on Reporting Impedance and pH Tests Together? Check CCI
Question: If our gastroenterologist is performing an impedance test for gastroesophageal... Read more
Reader Question:
Base DSMT Codes Reporting on Time and Provider
Question: A patient seen for diabetes (250.02) in the doctor’s office and the phys... Read more
You Be the Coder:
Using G0455 For All Microbiota Preparation? Think Again
Question: We have recently performed a fecal transplant on a patient with Medicare. In t... Read more
CPT® 2014 Update:
Incorporate New Esophagoscopy, Dilation, Stent & Resection Codes in 2014
Don’t forget to factor in descriptor changes to cover route of scope introduction.... Read more
2014 Physician Fee Schedule:
Get Set for More Fee Deductions if Proposed MPFS Sees Light
Good News: Chronic care non-face-to-face services might yield bonuses in 2015. While t... Read more
ICD-10 Update:
Drill Down for Functional Dyspepsia Specifics With K30
Hint: You cannot report K30 for psychogenic dyspepsia. When reporting a diagnosis of f... Read more
Reader Question:
Avoid Confusion While Reporting Two Chemotherapy Infusions
Question: Our physician recently performed the infusion of two anti-neoplastic subs... Read more
Reader Question:
Assign Appropriate V Codes For Screening Colonoscopies
Question: For BCBS and other third party insurance carriers, when a patient comes t... Read more
Reader Question:
Avoid Choosing Critical Care Codes Based on Location
Question: If our gastroenterologist saw a patient in the ICU for a consultation, ca... Read more
Reader Question:
Capturing PAs Work For Initial Nursing Facility Visits? Not so Fast
Question: I am receiving denial C0-170 (Payment is denied when preformed/billed by ... Read more
You Be the Coder:
Use Suitable Modifiers to Separate Two Endoscopic Procedures
Question: Our gastroenterologist recently performed an upper EGD on a patient. Duri... Read more
CPT® 2014 Update:
Prepare for Endoscopy, Ablation, ERCP Changes Next Year
Also watch for these new codes in E/M coming your way. Get ready to overhaul your endo... Read more
Key Elements:
Tactics Help You Choose the Right E/M Guidelines for Optimum Reimbursement
Hint: You have the choice to switch between the two E/M guidelines for every encounter. ... Read more
ICD-10 Update:
Peptic Ulcers Crosswalk to K27 in ICD-10
Hint: If cause is alcohol abuse, don’t forget to identify it additionally. When ... Read more
Clip and Save:
Refer This Handy Chart to Select Exam Levels With Precision
Select the guidelines that will carry the best advantage to your coding. With two sets... Read more
Reader Question:
Observe When to Report Imaging Guidance With Endoscopic Procedures
Question: Can the CPT® code ‘76975’ be used on all gastrointestinal endo... Read more
Reader Question:
Avoid Confusion Over Date of Service for Capsule Endoscopy
Question: When billing a capsule endoscopy 91110 do you put the date of procedure as the... Read more
You Be the Coder:
Capture Visualization and Obstruction Removals Separately
Question: Our physician performed an EGD with positioning and securing of jejunostomy tu... Read more
CCI 19.2 Update:
Don't Miss Edits Bundling E/M With Almost All Gastroenterology Procedures
In addition: Catch bundles affecting hemorrhoidectomy and paracentesis. Hold your hors... Read more
Money Matters:
Maximize Your Bonus Ethically By Choosing the Right PQRS Reporting Options
Hint: Use number of providers in your group to cue into right choice. If you’re ... Read more
ICD-10 Update:
Loop Into K56.1 For Intussusception Diagnosis
Hint: Use different ICD-10 code for a diagnosis of intussusception of the appendix Whe... Read more
Reader Question:
Check Reason for Ablator Use Prior to Coding
Question: How would you code a Barrx Halo and a snare polypectomy when the Barrx Halo wa... Read more
Reader Question:
Secure Proper Documentation for Solesta Injections
Question: Our gastroenterologist recently treated a patient with Solesta injection for f... Read more
Reader Question:
Know Reason For Same Day Office, ER Visits
Question: If a patient was seen for an office visit (99214) first and then later on the ... Read more
You Be the Coder:
Using Modifiers for Endoscopy and Unguided Dilation? Think Again
Question: I code for an ASC and one of our gastroenterologists does an endoscopy first, ... Read more
CPT® Coding Strategies:
Nail Your Gastrostomy Tube Change Claims With This Key Tactic
Hint: Stick to reporting E/M for removals without replacements. When your gastroenterolog... Read more
Payer Spotlight:
Be Clear About Additional Documentation Required for Modifier 22 Claims
Hint: Not all increase in duration for the procedure warrants this modifier. If  ... Read more
ICD-10 Update:
Straightforward Transition Eases Your Acute Gastritis Reporting
Hint: Use same basis for arrival at final code as in ICD-9. When your gastroenterologi... Read more
Reader Question:
Recognize When to Report E/M Separately With Colonoscopy
Question: My doctor saw a patient in the hospital and did a low level consult which I wo... Read more
Reader Question:
Get Clarification on Whether or Not a Nurse Can Change a PEG Tube
Question: Can a nurse change out a percutaneous PEG tube in the office? If so does a phy... Read more
Reader Question:
Don't Forget Administration Code When Reporting Hepatitis Vaccinations
Question: Can you provide me with the codes that I need to use for Hepatitis B vaccines?... Read more
You Be the Coder:
Document to Support Pre-Existent J Tube
Question: My doctor performed an EGD with biopsy but also removed and then replaced a J-... Read more
CPT® Coding Strategies:
Ace Your G-Tube Placement Coding With These Key Tactics
Hint: Append modifiers when two specialists are carrying out the procedure. When your ... Read more
Key Elements:
Cast Your Net for These PMFSH Details or Lose More Than $70 Per Encounter
Hint: Don’t overlook including history captured in previous visits. If your gast... Read more
ICD-10 Update:
Untangle Umbilical Hernia Diagnosis Knots With Simple Transition to K42
Hint: Presence or absence of gangrene is still the deciding factor to arrive at the righ... Read more
Reader Question:
Reporting Same Session Ablation and Snare Techniques? Not So Fast
Question: Are there specific times when a physician can use the ‘45383’, rat... Read more
Reader Question:
Know When to Report Multiple Units of 43256
Question: Our gastroenterologist recently performed a successful deployment of two fully... Read more
Reader Question:
Choose From Multiple CPT® Codes For Endomucosal Resection
Question: Our gastroenterologist did an EGD with endomucosal resection. I am having diff... Read more
You Be the Coder:
Use Unlisted Procedure Code Only as a Last Resort
Question: Our general surgeon recently performed a partial small bowel resection. During... Read more
CPT® 2013 Strategies:
Take the Stress Out of Your GI Pressure, Transit Measurement Reporting With This Advice
Hint: Obtain prior pre-authorization to avoid payer denials. You can improve your CPT&... Read more
Key Elements:
Strengthen Your ROS Documentation to Qualify For Level 4 or 5 Encounters
Don’t down code due to lack of complete documentation. If your gastroenterologis... Read more
ICD-10 Update:
Enjoy Straightforward Transition For Paralytic Ileus With K56.0
Hint: Distinguish from gallstone ileus or duodenal ileus to correctly nail the diagnosis... Read more
Reader Question:
Check Approach Before Coding Enteroscopy Procedures
Question: Our gastroenterologist recently performed a double balloon enteroscopy wherein... Read more
Reader Question:
Assess Risk to Arrive at Diagnosis Code Rather Than Payer Type
Question: We have patients from time to time whose benefit plans don’t recognize h... Read more
Reader Question:
Don't Fret Over CLIA Compliance for Sitzmark Tests
Question: Our new gastroenterologist just started using Sitzmark tests.  How shall ... Read more
Reader Question:
Only Checking Vitals Will not Allow You to Report Higher Level E/M
Question: A new patient presented in our office. Past medical, social, and family histor... Read more
You Be the Coder:
Discern Intent Rather Than Scope Type to Arrive at Appropriate Code
Question: Our gastroenterologist recently performed a colonoscopy to place a stent on a ... Read more
CPT® 2013 Strategies:
Zero In On The Right Endomicroscopy Code With This Advice
Hint: Don’t always report the interpretation of images separately. To accurately... Read more
Ordering/Referring:
6 Steps Reduce "Ordering/Referring" Edit Losses
Tip: Double check physician NPI is individual and not group practice NPI. If you have ... Read more
ICD-10 Update:
Look Forward to a Simple Crossover For Angiodysplasia of Colon
Hint: The presence of hemorrhage is still the final key to right code selection. Your ... Read more
Learn the Basics of Optical Endomicroscopy
Optical endomicroscopy (confocal endomicroscopy) is a new technique that has been develo... Read more
Reader Question:
Use Appropriate E Code To Complete NBS Diagnosis Reporting
Question: Our gastroenterologist recently made a diagnosis of Narcotic Bowel Syndrome. W... Read more
Reader Question:
Provide Adequate Documentation For Unlisted Procedures
Question: Our gastroenterologist recently performed exam under anesthesia, anastomotic d... Read more
Reader Question:
Choose The Right E/M Code Based on Medical Necessity
Question: Our gastroenterologist is a very thorough documenter. Because he documents his... Read more
Reader Question:
Check Payer Policies While Billing Other Drugs Administered With Anesthesia
Question: Our GI group owns its own endoscopic suite where colonoscopies are performed i... Read more
You Be the Coder:
Assess Dilator Type to Report Appropriate Dilation Code
Question: What CPT® code would you use for the following case scenario: &ldquo... Read more
Coding Tips:
Beware: Don't Automatically Use 44705 For Fecal Bacteriotherapy
Hint: Use additional code for instillation when reporting 44705. If your gastroenterol... Read more
Observe Coverage Criteria For Fecal Bacteriotherapy
Fecal bacteriotherapy (also known by other names such as stool transplant, fecal transpl... Read more
Modifier Tips:
Accurately Bypass CCI Edits With These Enhanced Modifier Options
Plus: Know when to use modifiers 24 and 57 Whenever two codes hit a coding bundle with... Read more
ICD-10 Update:
Expect Broader Reporting Options For Chronic Gastritis in ICD-10
Hint: The existence or lack of bleeding is still the final key to right code selection. ... Read more
Reader Question:
Avoid Coding Confusion For Same Day Stent Removal and Insertions
Question: Our gastroenterologist recently preformed an ERCP procedure to remove the orig... Read more
Reader Question:
Use Procedural Code When Colorectal Cancer Screening Turns Therapeutic
Question: Our gastroenterologist recently performed screening colonoscopy for a Medicare... Read more
Reader Question:
Don't Get Perplexed by Multiple Terms For Same Procedure
Question: How is a “colonoscopy” coded on a patient who has had a total proc... Read more
Reader Question:
Learn When to Append Modifier PD to Codes
Question: Please explain to me when to use modifier PD. Does this apply to us when a pat... Read more
You Be the Coder:
Choose 47000 For Standalone Liver Biopsies
Question: What CPT® code do you use if a liver biopsy was performed but no specimen ... Read more
CCI 19.0 Update:
Check CCI Bundling for Motility Studies and Capsule Endoscopy
Catch pairing with anesthesia and injection services too. When your gastroenterologist... Read more
Documentation:
Beware: Cloned E/M Documentation Could Put You on OIG's Hot List
Double check your EMR entries to avoid unnecessary attention. If you are in the habit ... Read more
ICD-10 Update:
K70.3 Offers Better Insight Into Alcoholic Cirrhosis of Liver in ICD-10
Look at detailed exclusions list to differentiate other causes of cirrhosis. If your g... Read more
Reader Question:
Don't Use Lab Encounter Codes Routinely
Question: One of our patients who need to undergo a CT scan with contrast is required to... Read more
Reader Question:
Get Benefits Verification on the Front End
Question: What caution and guidelines should I follow for a patient who has new coverage... Read more
Reader Question:
Add These Codes to Your GI Cocktail Billing Mix
Question: The patient documentation informs that our gastroenterologist administered a G... Read more
Reader Question:
Watch These Penalties for Illegible Documentation
Question: I have heard payers are cracking down on illegible provider documentation. My ... Read more
You Be the Coder:
Append Modifier to Capture Additional Time for Mesh Placements
Question: I recently encountered two different situations with laparoscopic fundoplicati... Read more
CCI 19.0 Update:
Beware: New Optical Endomicroscopy Codes Steal the Show in NME Pairings
Don’t forget to catch non-mutually exclusive bundles with fluoroscopy too. As yo... Read more
CPT® 2013 Update:
Don't Fret Over Far-Reaching E/M Terminology Change
Know when to apply the newly introduced transitional care codes. The most widespread c... Read more
ICD-10 Update:
Cholecystitis Sails Smoothly to K81 in ICD-10
Hint: Don’t code separately if the condition occurs with cholelithiasis or choledo... Read more
Reader Question:
Reporting Hep Flush Codes Separately -- Not So Fast!
Question: Patient is seen in the office and has a heparin flush of the port - Are we all... Read more
Reader Question:
Append Appropriate Modifiers to Unlock Multiple
Question: Our gastroenterologist recently performed an upper EGD procedure. During the p... Read more
Reader Question:
Plan Your Appeal Letters on a Case-by-Case Basis
Question: After checking to be sure we haven’t made a coding or billing entry erro... Read more
Reader Question:
Choose Appropriate Repair Code Based on Recurrence and Type of Hernia
Question: Our physician recently performed a laparoscopic umbilical hernia repair along ... Read more
Reader Question:
Wait For ICD-10 to Get Out of 'Unspecified' Appendix Code
Question: Our physician performed a procedure to remove the patient’s appendix. Th... Read more
Reader Question:
Extensive Documentation Does Not Necessarily Mean 99215
Question: Our physician is an amazing documenter — for established patients (which... Read more
You Be the Coder:
Be Aware of When to Use Modifiers for Polyp Removal
Question: Our gastroenterologist recently performed a polyp removal, using the snare tec... Read more
Coding Tips:
Overcome Multi-Provider PEG Tube Coding Challenges With This Expert Advice
Hint: Use same CPT® procedural code for each provider. Are two-physician PEG tube ... Read more
ICD-10 Update:
K70.1 Amplifies Alcoholic Hepatitis Options
Descriptor changes help eliminate chronicity confusion. If you’re reporting alco... Read more
Practice Management Tips:
Prepare For OIG's Scrutiny of Many Core Areas in 2013
Focus on self-audits to eliminate possible problems before the feds come calling. The ... Read more
Reader Question:
Avoid Confusion Over Billing Physician and NP Services on Same Day
Question: Our NP is working with our gastroenterologist in the same clinic. We are plann... Read more
Reader Question:
Verify Patient Info To Sidestep Co-pay Shortfall
Question: A patient came to our office with the same insurance card she’s had for ... Read more
Reader Question:
Do This When HPI Is Missing
Question: A new patient visits the physician with a chief complaint. I don’t have ... Read more
Reader Question:
Append Modifier Q6 When Locum Tenens Supervises NP Services
Question: One of our gastroenterologists will be away for ten weeks. He has made locum t... Read more
Reader Question:
Don't Forget to Report Sphincterotomy Separately Along With Dilation
Question: Our gastroenterologist recently performed an ERCP procedure during which he ex... Read more
Reader Question:
Understand When to Append Modifier PD
Question: Please explain to me when to use modifier PD. Does this apply to us when a pat... Read more
You Be the Coder:
Check Method Used to Remove Biliary Stent
Question: My gastroenterologist recently performed a biliary stent removal. He didn&rsqu... Read more