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Gastroenterology Coding Alert

Pre-Colonoscopy Visits:
Determine When E/M Is Billable With Screening Colonoscopy
Hint: Perform a quick audit of your claim to determine whether it's billable. Gastroenter... Read more
E/M Coding:
This Part B MAC Busts 5 Commonly-Held E/M Coding Myths
Worried about "double dipping" for ROS and HPI? Fear not, this rep. says. Coders face thi... Read more
Ring in the New Year With Top-Notch Billing, Collections Policies
Make 2018 your most profitable year ever with these tips. As gastroenterology practices p... Read more
Deductibles Vs. Coinsurance: How Can You Collect?
Collecting copays may be straightforward, but delving into deductibles and Medicare coinsu... Read more
You Be the Expert:
In Some Cases, Injection With Endoscopy Is Payable
Question: Our gastroenterologist performed an endoscopy with submucosal injection procedur... Read more
Reader Question:
FNA May Be Bundled
Question: A 62-year-old male was recently diagnosed with a rectal adenocarcinoma by colono... Read more
CPT® 2018:
CPT® 2018 Brings New Endoscopic GI Anesthesia, Abdominal X-Ray Codes
Plus: Look for revisions to total esophagectomy codes as well. If you were pleased to fin... Read more
Endoscopy Coding:
Evaluate Your Lower GI Scope Coding Skills With 3 Quick Questions
If your lower GI scope coding skills are limited to colonoscopies, you've got some catchin... Read more
Use Modifier 57 to Maximize E/M Pay With Procedures
Is modifier 57 necessary? If the decision for surgery was made that day, then it probably ... Read more
You Be the Expert:
Know When Modifier PT Is Required
Question: In your last issue, you discussed coding for a screening colonoscopy turned... Read more
Reader Question:
Differentiate Impedance Testing Codes
Question: If our gastroenterologist is performing an impedance test for gastroesophag... Read more
Reader Question:
NSAID Administration Bundles Into E/M Code
Question: Is there a code that I can use for the administration of Tylenol or Motrin?... Read more
Reader Question:
Use These Tips to Differentiate Diverticulosis, Diverticulitis
Question: I'm new to gastroenterology coding, and I'm wondering what the difference i... Read more
Op Note Coding Quiz:
Can You Code These Op Reports? Take Our Quiz to Find Out
These are 3 of the most commonly-reported GI procedures - test whether you know how to rep... Read more
Check Out These Quick Op Note Coding Tips
If coding op notes isn't your specialty, these pointers can help. Some coders thrive on c... Read more
United Healthcare: You Must Now Use Modifier SA on E/Ms Performed by NPPs
If the NP, PA, or CNS performs an E/M, modifier SA will be essential when billing UHC. Re... Read more
These 5 Tips Help Keep Your Practice Free From Fraud and Abuse Accusations
Hint: The provider is responsible for every claim submitted to payers. Sometimes handling... Read more
You Be the Expert:
Know the Anorectal Abscess Diagnoses
Question: How do we report an anorectal abscess under ICD-10? Subscri... Read more
Reader Question:
Don't Spend Time Seeking PEG Removal Code
Question: One of our gastroenterologists performed an EGD on a patient on one day and... Read more
Reader Question:
Missing Organ Doesn't Mean Missing ROS
Question: If the physician examines a patient who has had an organ removed, can we st... Read more
Reader Question:
Document Discharge Time or Expect Payment Cut
Question: One of our surgeons never documents time for a hospital discharge. How shou... Read more
Part B Fee Schedule:
2018 Medicare Fee Schedule Proposes Major Updates to E/M Documentation
Plus: Check out these potential new esophagectomy codes. CMS has released its 2018 propos... Read more
Behind the Numbers:
Find Out How the MPFS Proposal Could Impact Your Pay
Are fees going up or down? Potential changes to E/M codes aren’t the only shakeup t... Read more
Practices Billing This Payer Will See Modifier 25 Pay Slashed by 50 Percent
Could you afford to lose half of your E/M payments? Gastroenterologists typically use mod... Read more
ABN Usage:
3 Scenarios Guide Your ABN Use at Every Expertise Level
We’ve got one question for each coder — beginner, intermediate, and advanced. ... Read more
You Be the Expert:
Can You Report a Service When Patient Isn't Present?
Question: We had a patient’s son present to talk about his mother’s colon... Read more
Reader Question:
Don't Look for New ID Cards Just Yet
Question: A Medicare patient came to our practice and said she isn’t allowed to... Read more
Reader Question:
Nail Down Number of Dx Codes
Question: Must we report the ICD-10 codes for all the current conditions that the pat... Read more
Breaking: You'll Find New Intestinal Adhesion Codes on Oct. 1
CMS has released the finalized list of 2018 diagnosis codes. Gastroenterology coders hopi... Read more
Colonoscopy Coding:
3 FAQs Guide Your Colonoscopy Codes at Every Expertise Level
We’ve got one question for each coder — beginner, intermediate, and advanced. ... Read more
This One Key Issue Could Be Holding You Back From Collecting More Income
The first step to collecting? Eliminate the “bill it and forget about it” scho... Read more
You Be the Expert:
Update Your Software to Prevent Viruses
Question: During an ERCP, the gastroenterologist made numerous attempts with the cath... Read more
Reader Question:
Update Your Software to Prevent Viruses
Question: Our practice hasn’t updated its computers in a few years and we have ... Read more
Reader Question:
Differentiate Split/Shared E/M From Incident-to
Question: Can you please explain the difference between a split/shared evaluation and... Read more
Reader Question:
Don't Forget to Document Time During Discharges
Question: To ensure that you’re properly reporting the hospital discharge codes... Read more
New Proposed Codes Could Change Your Diverticulitis Coding in October
Appendicitis, cholelithiasis are also diagnosis codes to watch. Diverticulitis coding cou... Read more
E/M Coding:
Navigate the Thin Line Separating 99211 From Non-Billable Visits
Can an Rx pickup constitute a 99211? In very rare cases, yes. Gastroenterology practices ... Read more
Patient Privacy:
Lack of Signed BAA Cost This Gastroenterology Group $31,000
Business agreements can protect everyone involved. If your practice takes business associ... Read more
Reader Question:
Know How MACRA Payments Work
Question: How does quality reporting under MACRA relate to earlier programs such as P... Read more
Reader Question:
Turn to Unlisted When Warranted
Question: Our gastroenterologist performed endoscopic tissue marking with the assista... Read more
Reader Question:
Prep for This Common Patient Question
Question: One of our patients called the other day and asked us several questions abo... Read more
Reader Question:
Critical Care Rules Apply Across the Age Gap
Question: Our gastroenterologist has never done rounds at a children’s hospital... Read more
You Be the Coder:
Does Number of Stones Decide Number of Codes?
Question: We performed stone removal during an endoscopic retrograde cholangiopancrea... Read more
Hospital Coding:
CMS: Gastroenterologists Logged Highest Initial Hospital Visit Error Rates
Avoid making the same mistakes these doctors made. You see a patient in the hospital and ... Read more
4 Q&As; Help You Report Signs and Symptoms
Many gastroenterology claims lack definitive diagnoses — so use these codes to colle... Read more
Do You Know How Your Code Usage Stacks up to Other Gastroenterologists'?
Create a benchmarking analysis to determine where you stand. Medical practice staffers of... Read more
Clip And Save:
Here's Your Breakdown of Which Codes Gastroenterologists Are Reporting Nationally
Once you compare your practice’s benchmarking data over time, you may want to take t... Read more
You Be the Expert:
Colonoscopy Guidelines Differ Based on Risk Level
Question: Can we perform a colorectal cancer screening on a 51-year-old patient every... Read more
Reader Question:
PEG Tube Removal May Not Warrant 43760
Question: Our surgeon removed a PEG tube in the office and circled 43760 on the super... Read more
Reader Question:
You Can Bill Medicare Even If You Aren't Enrolled
Question: Our gastroenterology practice sees primarily pediatric patients at a childr... Read more
A Quick-Start Guide to Getting Reimbursed for GERD Treatments
Here’s how to get insurers to pay for 43284. The standard treatment for GERD (gastr... Read more
Revenue Booster:
Patient Reactivation Is a Marketing Tactic That Yields High ROI
Tip: Keep a list of patients with chronic patients who don’t have upcoming appointme... Read more
You Be the Expert:
Keep Bariatric Surgery Requirements in Mind
Question: Our physician performed bariatric surgery for an obese patient with coronar... Read more
Reader Question:
Always Revert Back to the New Patient Rules
Question: I am aware of the new patient rules, but this situation is a new one for me... Read more
Reader Question:
Don't Count on LINX Payment
Question: We had a patient present at our practice who had been referred by his gener... Read more
Reader Question:
Always Check CCI When Denials Arrive
Question: Our gastroenterologist performed a duodenal intubation as well as a gastric... Read more
Reader Question:
Yes, PMFSH Matters
Question: Our doctors are great about documentation, except in one area. They rarely ... Read more
Reader Question:
Timed Codes Require Timed Notes
Question: Our physician reported G0446 and we were audited. We submitted the records ... Read more
Reader Question:
Check the Non-Coverage Criteria for EGDs
Question: We performed an EGD on a patient whose x-ray showed a sliding hiatal hernia... Read more
Got Drug Leftovers? Get Your JW Modifier Basics Right
Count your units carefully to accurately append JW to J1745. Since Jan. 1, you should hav... Read more
Tips for Filing Claims with JW
It’s all in the details. Figuring out how to accurately use modifier JW might feel ... Read more
Three HCPCS Codes Enhance Your Colonoscopy Quality Reporting
Explore the new options for coding past history, pre-colonoscopy consultation, and more. ... Read more
Practice Management:
Survive and Thrive in the Age of HDHPs
Heads up: Out-of-pocket revenue is a greater share of your gastroenterology practice&rsquo... Read more
The New Revenue Reality: High-Deductible Health Plans (HDHPs)
230%: Percentage increase in average annual out-of-pocket costs per patient from 2006-2015... Read more
Patient Engagement:
Can Mobile Patient Engagement Help Your Gastroenterology Practice with Private Pay Collections?
Preliminary data from large health care systems says, ‘Yes!’ With the rise of... Read more
7 Tips for Billing Statements That Pay Up
Too many days in A/R? Chances are your gastroenterology patients don’t understand yo... Read more
You Be the Expert:
Sharpen Your EGD Coding Skills
Question: A patient complains of pain in swallowing, acidity and regurgitation at tim... Read more
Reader Question:
Don't Forget Modifier 33 for a Preventive Service
Question: A patient, with a personal history of colon polyps, comes to the provider f... Read more
Reader Question:
Report Moderate Sedation Separately with EGD in 2017
Question: The provider performs an EGD procedure to resect an ampullary polyp. How do... Read more
Upgrade Your Fecal Microbiota Transplant Coding Skills
Billing Medicare? Understand the differences between 44705 and G0455. If your gastroenter... Read more
Learn Gastro Quality Measures to Maximize 2017 MIPS Bonuses
These measures are a means to meet your MIPS minimum and potentially reap a bonus in 2019.... Read more
Practice Management:
Master Your A/R Challenges With 5 Tested Tactics
If you don’t regularly scrutinize your accounts receivables, you’re probably l... Read more
You Be the Expert:
RACs Are Watching Discharge Codes
Question: Our physician was one of the doctors who saw a patient in observation care ... Read more
Reader Question:
Some ICD-10 Codes Don't Apply to Newborns
Question: Our gastroenterologist was on rounds at the hospital and was called to eval... Read more
Reader Question:
Watch Your Dx Code for Remicade Infusions
Question: We have been treating a patient with Remicade for years to treat her Crohn&... Read more
Master Your Screening Colonoscopy Coding in a Jiffy
Know the difference between screening, diagnostics and surveillance. Do you feel uneasy w... Read more
NCCI Edits:
Grab the 3 Must Know GI Codes Within the NCCI Edits Erroneous List
Stay calm, and wait for next quarter edits to ameliorate the issue. Did news of the la... Read more
ICD-10 Quiz:
Power up Your ICD-10 Coding Skills with These 4 Scenarios
Dig deeper into the code descriptor to explore what the K57 category contains. Are you... Read more
Reader Question:
Explore Your Options for Esophageal Motility Study
Question: The provider did an esophageal “motility study” to evaluate t... Read more
Reader Question:
Can Anemia Preempt A Colonoscopy?
Question: A 55 year old patient is diagnosed with iron deficiency anemia. He had a ... Read more
Reader Question:
Learn the Difference Between Diagnostic and Therapeutic Sigmoidoscopy
Question: What is the difference between diagnostic and therapeutic sigmoidoscopy? ... Read more
You Be the Coder:
Take the Guesswork Out Of Discontinued Colonoscopy
Question: The provider attempted to perform a diagnostic colonoscopy for a patient.... Read more
5 Coding Scenarios Ease Your GERD Coding Heartburns
Don’t hesitate to report 43239 with 91035 on the same day. Do you get sick to yo... Read more
ICD-10 Update:
Master 77 Crohn's Disease and Ulcerative Colitis Codes with a Single Stroke
Be sure to specify the complications or lack thereof in your fifth and sixth digits. A... Read more
CPT® Update:
Get New Codes for Esophageal Sphincter Augmentation Device in 2017
CPT® 43284-43285 replace the Category III codes 0392T-0393T Get ready to report tw... Read more
Reader Question:
Use Modifier 78 to Maximize Revenue from Post-Procedure Visits
Question: A Medicare patient underwent a colonoscopy in the morning. He returns to th... Read more
Reader Question:
Will Just One Code Suffice For Replacing A G Tube? Find Out
Question: According to the op note, the provider inserted the gastroscope to the bo... Read more
You Be the Coder:
Know the Right Codes for Lithotripsy with Stent Removal
Question: The provider performed stone removal using lithotripsy and also removed o... Read more