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Gastroenterology Coding Alert

Injection Coding:
Energize Your Endoscopic Injection Reimbursements With 5 Simple Rules
Don’t miss opportunities to code multiple injections despite restrictions. If yo... Read more
E/M Corner:
Mark Your MDM Accurately to Maximize E/M Payment
Reporting the entire panel of tests upon confirmed diagnosis may land you in trouble. ... Read more
Modifier Mix:
Manage Your Multi-Provider Services With Modifier 62
Forfeit your payment if both physician’s claims don’t reflect the modifier u... Read more
Reader Question:
Reason to Stop Endoscopy Procedure Decides Modifier 52, 53
Question: Our gastroenterologist was performing a diagnostic EGD. While inserting t... Read more
Reader Question:
Limit Yourself to E/M for Buccal Colaris Testing
Question: A patient came in our office for a Buccal Colaris genetic test based on f... Read more
You Be the Coder:
Don't Reach Automatically for 45915 for Rectal Disimpaction in Office
Question: A physician is doing a manual disimpaction of the rectum under anesthesia... Read more
ICD-10 Coding:
Keep This Colonic Polyp Code Guide at Hand to Maximize Returns
Distinguish between non-neoplastic and neoplastic polyps will save your bacon. Colonic... Read more
CPT® 2016:
Get Ready to Welcome New and Revised Prolonged Services Codes Next Year
Revised codes can be added on to any service level, not just the highest. Change has ... Read more
GERD Testing:
Confront Esophageal Manometry Coding Challenges Head-On With This Refresher
Don’t use codes 0240T and 0241T for CY 2016. As a gastroenterology practice, you... Read more
Reader Question:
Don't Expect a Direct Diagnostic Code for Reporting Lynch Syndrome
Question: We are seeing Lynch syndrome cases. What are the best diagnosis codes to ... Read more
Reader Question:
Let the Actual Procedure Performed Guide Your Colonoscopy Codes
Question: A patient who had total colectomy and still had a rectal stump visited ou... Read more
Reader Question:
Do Not Combine 74360 With 43233 for Balloon Dilation >30 mm
Question: Our gastroenterologist recently performed an EGD on a patient with achala... Read more
You Be the Coder:
This Handy Guide Unlocks Your Transendoscopic Stent Placements Coding
Question: We received a case a few days in which the GI placed a duodenal stent dur... Read more
Endoscopy Clips:
Learn the Ins and Outs of Coding Gastro Clips With These Handy Tips
Cut out unnecessary steps when reporting endoscopic marking clips. Has your gastroente... Read more
Reimbursement Roundup:
Modifier PT Helps Your Practice Capture Screening-Turned-Diagnostic Colonoscopy Pay
Hint: Do not use the modifier PT when the service began as a diagnostic procedure. Alt... Read more
E/M Corner:
Back Up Your Level of E/M Services With Medical Necessity
Key: MDM and medical necessity are not the same. If you are reporting high-level E/M c... Read more
Reader Question:
Get RVU Priorities Right Before Billing Biopsies With Dilation
Question: Our GI recently performed an esophageoduodenoscopy with biopsies and esop... Read more
You Be the Coder:
Verify Medical Necessity for Successful Capsule Endoscopy Payment
Question: We recently purchased the PillCam™ Given Capsule technology to use ... Read more
Colonoscopy Pointers:
Use These Tips To Conquer Colonic Polypectomy Codes
Use biopsy codes for polypectomy in case of cold forceps. You are looking at a loss of... Read more
Screening Tests:
Frequency Rules and Risk Categories Call the Shots in Colonoscopy Screenings
Watch out: Medicare has specific requirements other payers might not follow. Colon can... Read more
RVUs Refresher:
Keep Up On PFS by Building a Comprehensive Understanding of RVUs
Break down the components of your payment. The Centers for Medicare and Medicaid Servi... Read more
ICD-10 News:
Medicare To Go Lenient on Diagnosis Coding Specificity Next Year
Avoid future problems by working with your physicians on added specificity. There is g... Read more
Reader Questions:
Use 99304-99318 Only for Ongoing Care Not For Nursing Home Consultations
Question: Recently, our gastroenterologist admitted a patient to the hospital direc... Read more
You Be the Coder:
Choose Between Guided and Unguided Insertion Before Coding Dilation
Question: Our physician performed an esophagoscopy on a Medicare patient before the... Read more
Upper GI Spotlight:
EGD Or Enteroscopy? Enlist These Tips For Reimbursement Success
Documented intention and medical necessity is the key to coding the procedure. You hav... Read more
Modifier Mashup:
Make Modifier 22 Pay You For That Extra Physician Work
Demonstrate the unusual nature of the procedure and ask for payment You can stand to a... Read more
Part B Payment:
Brace Yourself for Changes in Incident to Services, Gastro Pay Coming January
2016 could also usher in advance care planning payments. After a long interval, there ... Read more
Modifier Update:
CMS Admits to X(EPSU) Modifiers Not Being as Effective as Planned
Modifier 59 usage in its current form may be allowed until further notice.  Many ... Read more
Reader Questions:
Colonoscopy With Polyp Removal? Look at the Scope Entry
Question: Our office has not one, but two, coding questions about removing polyps v... Read more
Reader Questions:
Track Updated CPT® and Medicare Codes Before Billing Colonoscopy
Question: Our gastro performed a colonoscopy with BICAP ablation of AVM for a patie... Read more
Reader Questions:
Ask for Payer Preference Before Modifying 43248 and 43239 With 59
Question: Our gastroenterologist performed an EGD with dilation and also biopsy on ... Read more
You Be the Coder:
Call On Mod 52, 53 for Rescue in Incomplete ERCP Procedures
Question: I’m coding an ERCP, and the doctor made numerous attempts with the ... Read more
Fecal Testing:
Fortify Your Payment for FOBT Services With These Tips
Get your patient involved before billing 82270. Coding for your gastroenterologist&rsq... Read more
Modifier Mashup:
Preserve Your Postop Procedure Reimbursement With Modifier 58
Get the staging right by scanning the op notes. Choosing the right modifier to represe... Read more
ICD-10 Update:
Get Ready to Assign R10 codes for Abdominal Pains
What is the trick for painless reporting of abdominal pain? Hint: The symptom is simpl... Read more
ICD-10 News:
Enjoy Extended Coverage With Transition Period Proposal
HHS to prove readiness and provide 18 months cover from denials. Get ready for the lat... Read more
Reader Questions:
Let Technique Decide Varices Treatment Codes
Question: Our gastroenterologist recently performed an esophagoscopy and found vari... Read more
Reader Questions:
Report Infectious Pouchitis With Supporting Dx Codes
Question: What diagnosis code should I use for pouchitis? Does the ICD-9 code chang... Read more
You Be the Coder:
Don't Let Separate DOS Confuse Your Paracentesis Claims
Question: The gastroenterologist performed paracentesis on a patient to drain fluid... Read more
Procedure Coding:
Level up on the Latest Lower GI EUS Coding With These 4 Pointers
Go through the new Medicare allowed codes before reporting latest 2015 codes.  As... Read more
CPT® 2015:
Clear the Confusion on 'Abridged Colonoscopy' Coding with These Tips
Look at new ‘decision tree’ to get clear choices. How to code a colonoscop... Read more
ICD-10 Countdown:
Train Your Sights on October ICD-10 Transition With These 6 Steps
Tip: Practice ‘dual coding’ to land on your feet running after October. Wi... Read more
Readers Queries:
Specify the Site of Stricture Before Reporting EGD With Bougie Dilation
Question:  A patient recently visited our office with a complaint of dysphagia. Our... Read more
Readers Queries:
Biopsy Takes First Priority for Multiple Colonoscopy Procedures
Question: Our physician recently performed a colonoscopy with polypectomy and also ... Read more
Readers Queries:
Avoid Reporting Screening Codes for Colonoscopy Based on Symptoms
Question: A 48-year-old patient complaining of chronic heartburn, cough, and cramps... Read more
Readers Queries:
Visit Revised Codes Before Reporting Lower GI Codes for 2015
Question: Our surgeon performed a colonoscopy through a stoma for a patient with a histo... Read more
You Be the Coder:
Report Biopsy with EGD According to Methods Not Sites
Question: The documentation states that the gastroenterologist performed an EGD and... Read more
Procedure Coding:
Answer 3 Questions to Ace Your Upper GI EUS Claims
Report the EGD EUS only if your gastroenterologist has documented this procedure. ... Read more
Medicare News:
Lock In On Lower GI Procedures for Medicare With New 'G' Codes
Heed non-recognized CPT® codes before coding procedures. Maybe you’re thrill... Read more
Appendectomy Coding:
Avoid Raising Appendectomy Claim Red Flags With These Tips
Heads up: You have more options besides 44955. You may consider appendectomy as a bund... Read more
Readers Questions:
Read Your Local Payer Rules Before Reporting Botox Injections for Anal Fissures
Question: We have a new gastroenterologist who recently advised Botox to a patient ... Read more
Reader Question:
Double Check Colonoscopy CPT® Codes Before Reporting for Medicare
Question: Recently, during a colonoscopy our physician removed polyps from descendi... Read more
You Be the Coder:
Dig Out Different Diagnosis Codes Before Reporting E/M With Screening Colonoscopy
Question: A high-risk patient came in for a screening colonoscopy to our gastroenterolog... Read more
Infection Testing:
Best Practices Keep Your H. pylori Test Coding on Track
Tip: Heeding local payer criteria for testing is crucial for getting paid. If you gast... Read more
Hepatitis Screening:
Handle Hepatitis C Screening Smoothly With New HCPCS Code
Repeated screening is no longer taboo for high-risk patients. You’ll find your p... Read more
ICD-10 Update:
Get Ready to Discover Other Symptoms Before Coding IBS in ICD-10
IBS code shares the ICD-10 code address with spastic colon. Presence of diarrhea sympt... Read more
ICD-10 Prep:
Gear Up for the ICD-10 Shift With Training Programs and Testing
Participate in the upcoming testing drives in March and June to check your preparedness.... Read more
Reader Questions:
Double Check Payer Accepted Dx Codes to Avoid Kickbacks
Question: Our physician performed stent exchange on a patient with stricture of the... Read more
Reader Questions:
Pause Briefly Before Coding Repeat Consults
Question: How often can we report consult codes for the same patient? Our gastroent... Read more
You Be the Coder:
Hone Your Hepatitis Injection Reporting With This Ready Reckoner
Question: Our gastro office is getting queries about hepatitis A and hepatitis B vaccina... Read more
Consult Services:
5 Tips Help You Ace Your Inpatient Consult Coding
You can bill initial visits again on re-admission of a discharged patient. When your g... Read more
Modifier Alert:
Master These Modifier 52 and 53 Differences for Deserved Dollars
Forego modifier 53 when the patient voluntarily decides to stop the procedure. When yo... Read more
ICD-10 Update:
Proceed to Painless Reporting of Abdominal Pain With R10 Codes
New codes introduced give more options for colic and severe abdominal pain. What&rsquo... Read more
Readers Question:
Don't Abandon Modifier 59 Completely for X(EPSU)
Question: Is modifier 59 still valid as modifier for colonoscopy CPT® codes 453... Read more
Readers Question:
Control of Bleed Pays Only as a Primary Procedure
Question: Our gastroenterologist just attended to a Medicare inpatient and performe... Read more
Reader Question:
Unlisted Code is the Last Resort for Colonoscopy Procedures
Question: Our GI performed a colon screening through stoma for a Medicare patient w... Read more
You Be the Coder:
Modifier 22 Comes to the Rescue in Complicated Excision Procedures
Question: Our GI was performing a polyp excision recently and he documented the pol... Read more
Procedure Coding:
3 Tips Help You Ratchet Up Your Sigmoidoscopy Accuracy
Knowing the correct situations to report control of bleeding will help avoid denials. ... Read more
Modifier Update:
Modifier 33 is Your Key to Unlocking Screening Denials
Not all payers are on board, so keep your eyes peeled for individual LCDs. If you want... Read more
E/M Pitfalls:
Avoid These Top E/M Coding Traps to Prevent Claim Rejection
Adept handling of documentation will ensure reimbursement nirvana. You may be an old h... Read more
ICD-10 Update:
Screening Colonoscopy Gets a Direct Crossover
Medical necessity is pivotal for preventive service. With the implementation date of O... Read more
Readers Question:
Extent of Scope Insertion Decides EGD Codes
Question: Our GI performed attended to two patients for esophagogastroduodenoscopy ... Read more
Readers Question:
Sigmoidoscopy + Hemorrhoidectomy With Ligation Gets a New Address
Question: Our GI was performing a flexible sigmoidoscopy on a patient in our office... Read more
Reader Question:
Avoid Mistaking Specimen Collection for Biopsy
Question: During a patient’s routine screening colonoscopy, our gastroenterol... Read more
You Be the Coder:
Site of Analysis is important in Reporting C-14 Breath Test
Question: Our gastroenterologist recently saw an established patient with prolonged... Read more
GI Tract Imaging:
Smoothen Out Your Capsule Endoscopy Wrinkles With These Tips
Watch out for new code 0355T for colon imaging.  Your gastroenterologist has just... Read more
Don't Let Modifier Glitches Sideline Your Capsule Endoscopy Claims
Ask for pre-authorization from the carrier to repeat a capsule study due to previous tec... Read more
Audit Alert:
Heed These Documentation Cues to Avoid Audit Gaps
Pass the four-pronged test employed by CERT reviewers. You don’t want to be on a... Read more
ICD-10 Update:
Direct Matches Simplify Your Noninfectious Gastroenteritis Reporting
Focus on the cause for arriving at the right ICD-10 code. If your gastroenterologist d... Read more
Readers Question:
Go to G0472 for Reporting Hepatitis C Screening
Question: Our GI just saw a Medicare patient and advised her to undertake a hepatit... Read more
Readers Question:
Check Off These Conditions to Justify Consult Visit
Question: Our GI attended to a new patient. She said that she was advised by her PC... Read more
Reader Question:
Fearlessly Report EGD and PillCam® Capsule Together
Question: Can we bill for a capsule placement by doing an EGD in an ASC and get rei... Read more
Reader Question:
Check Payer for Exact Rules on Botox Injection Rules
Question: My physician’s documentation states that he performed esophagoscopy... Read more
You Be the Coder:
Watch Out For 90-Day Global for Hemorrhoid Procedure
Question: Our gastroenterologist saw a patient in the office visit with subsequent ... Read more