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Gastroenterology Coding Alert

Medicare Screening:
Colorectal Screenings Go Beyond Colonoscopies – Can You Code Them All?
From FOBT to screening barium enemas, know how to report these services. Your gastroenter... Read more
E/M Coding:
Ensure That Time Is on Your Side
Choose your E/M coding approach wisely. Most gastroenterologists code their E/M services ... Read more
5 Tips Help You Master 99211
Tip: Always watch out for bundles. Whether you report it every day or you avoid it like t... Read more
Reader Question:
Differentiate Between Prolonged Service Types
Question: We bill based on time pretty frequently, particularly when we see pediatric pati... Read more
Reader Question:
Same Polyp Ablated, Removed? Report One Code Only
Question: The provider identified a 10 mm semi sessile polyp in the ascending colon, and r... Read more
You Be the Coder:
How Should You Report Proctopexy?
Question: Our gastroenterologist circled 45130 for this note, but it doesn't seem to fit t... Read more
CPT® 2019:
Latest CPT® Edition Features New G-Tube Codes
Plus: You'll find 46762 on the deleted list for this year. If you ever felt like your exi... Read more
Entyvio Coding:
J3380 Is Gastroenterologists' Second Most-Billed Code – Can You Bill It Properly?
Entyvio infusions are common at GI practices, but remain a coding enigma to many people. ... Read more
Medicare Documentation:
Avoid Claim Denials With 5 Quick Signature Tips
Thousands of claims are denied each year due to this issue — don't be a statistic. When... Read more
Reader Question:
Symptoms Have Different Rules Than Suspected Diagnoses
Question: I enjoyed your article last month covering the diagnosis coding for patients who... Read more
Reader Question:
Know When Signs, Symptoms Should Be Billed
Question: Our new EHR seems to capture more diagnoses than ever and automatically tacks th... Read more
You Be the Coder:
Pinpoint Who Can Report Initial Hospital Care
Question: Our gastroenterologist saw a patient in the hospital for a surgical evaluat... Read more
ICD-10 Quiz:
Can You Answer These Diagnosis Coding Questions?
From generalized pain to Barrett's Esophagus, see if you can nail down these Dx codes. As... Read more
Upper GI Endoscopy:
Find the Right CPT® Code From This Op Note
EGD codes can be difficult to differentiate – use these tips for help. When it comes to... Read more
Advanced Practice Providers:
One MAC Makes Big Changes to Claim Processes When NPPs Performs E/M
NGS Medicare's change will impact NPs, PAs, especially at multispecialty practices. Multi... Read more
Reader Question:
OIG Adds Critical Care to Work Plan
Question: Our gastroenterologist will occasionally be called to consult in the ICU to eval... Read more
Reader Question:
Most Screening Colonoscopies Don't Warrant E/M Codes
Question: We reported 99213 as well as the colonoscopy screening code G0121, and we use mo... Read more
You Be the Coder:
Is There A Code for NG Tube Removal?
Question: Our gastroenterologist was called to evaluate a patient whose NG was in the esop... Read more
Part B Payment:
Will Proposed E/M Changes Hurt Or Help Your GI Practice?
Hint: Proposal would cause one practice in our sampling to lose $25,000 in a year. If you... Read more
Part B Payment:
Check These Additional Fee Schedule Proposals
Plus: What's the proposed conversion factor for 2019? Although the potential E/M changes ... Read more
ERCP Coding:
Know the Rules for Biliary, Pancreatic Duct Surgery
From stone removal to ERCP, we've got your coding solutions. GI endoscopists frequently p... Read more
You Be the Expert:
Heed These Colonoscopy Documentation Rules
Question: Our payer requested documentation of our colonoscopy claim and we submitted all ... Read more
Reader Question:
Streamline E/M Coding With Specifics
Question: When coding an E/M chart, how do we know where the “current” conditions/symp... Read more
Reader Question:
Know How to Differentiate Anoscopy From Proctosigmoidoscopy
Question: Our GI physician saw a patient complaining of abdominal cramps, frequent bowel m... Read more
Reader Question:
Know Sequencing Rules for HIV Patients
Question: Our gastroenterologist saw an HIV-positive patient for treatment of numerous chr... Read more
New Abscess, Gallbladder, Cholangitis Codes to Debut Oct. 1
Official updates to 2019 are out — how will your GI practice be affected? Whether you'v... Read more
Working With Business Associates? What You Must Know
Hint: First, find out what constitutes a BA. The HIPAA Privacy Rule clearly outlines what... Read more
Business Associates:
BAAs Aren't Always the Answer
Contracts differ according to the access and disclosure levels of PHI. Many of the people... Read more
You Be the Expert:
Can Non-Par Practices Really See Medicare Patients?
Question: I enjoyed your article last month offering tips for physicians that are new to t... Read more
Reader Question:
Check These Additional New Diagnosis Codes
Appendicitis gets additional specificity effective Oct. 1. The ICD-10 Committee debuted m... Read more
Reader Question:
Should We Choose 1995 Or 1997 Guidelines?
Question: We have traditionally used the 1995 E/M guidelines when making our code selectio... Read more
Reader Question:
Get to Know NP's Scope of Service
Question: We were very interested in your article last month about advanced practice provi... Read more
ICD-10 Coding Quiz:
Can You Pinpoint These GI-Specific Diagnoses?
Read these case studies and see if you can determine the right ICD-10 codes. Leafing thro... Read more
Medicare 101:
5 Facts All New Medicare Providers Need to Know
Get the scoop on how Medicare works and what you'll need to collect. If you have a new pr... Read more
Advanced Practice Providers:
Are You Correctly Reporting Your APP's Services?
Submit your advanced practice provider's services on every claim to maximize reimbursement... Read more
Reader Question:
Calculate BMI Carefully
Question: Our physician has recently started performing gastric bypass surgeries and we're... Read more
Reader Question:
Know When Modifier 52 Applies
Question: In your question last month entitled “Which Modifier Applies to This Case?” ... Read more
Reader Question:
Are You Watching the Calendar?
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
Reader Question:
Consider How to Report This Crohn's Case
Question: Our surgeon treated a patient with Crohn's disease who had both a colon perforat... Read more
You Be the Coder:
Can You Code This Clip Placement?
Question: If, during an endoscopy procedure, the doctor accidently tears the esophagus and... Read more
One MAC Released Its Top Denial Reasons for 2018 – Is Your GI Practice at Risk?
Hint: Nail down your documentation so you don't commit these infractions. If denials at y... Read more
Auditors Turn Focus to E/M Claims
Answer these FAQs to see if your E/M coding is up to par. Think you know the E/M rules in... Read more
This Gastroenterology Practice Is In Hot Water for Privacy Violations
Is your practice at risk of these problems? You might think that most HIPAA breaches are ... Read more
You Be the Expert:
Which Modifier Applies to This Case?
Question: Our gastroenterologist began performing an upper GI on an inpatient in the hospi... Read more
Reader Question:
Use This Advice When Considering EGD Appeal
Question: We recently reported esophagogastroduodenoscopy (EGD)/upper endoscopy for a 13-y... Read more
Reader Question:
Nail Down E/M Coding Rules
Question: When coding an E/M chart, how do we know where the "current" conditions/symptoms... Read more
Reader Question:
Know the Rules for Prolonged Service Coding
Question: We are hoping to bill a private payer for a prolonged service but we didn't see ... Read more
Bleeding Control:
Pinpoint Answers to These 3 Bleeding Control FAQs
You can sometimes collect for this service, if you know the rules. Bleeding control can b... Read more
Latest CCI Edition Takes Aim at Colectomy Codes
Do you know how this will affect your claims? April 1 has come and gone, so you should al... Read more
Ensure GI Surgery Pay With These Diagnosis Tips
When should symptoms be reported? You know that medical necessity drives payment for your... Read more
You Be the Expert:
Can You Code A "Corkscrew Esophagus?"
Question: Our physician diagnosed a patient with a "corkscrew esophagus." We have never se... Read more
Reader Question:
Know the Secondary Payer Rules
Question: We recently saw a patient with Tricare and Medicare, and we billed the claim to ... Read more
Reader Question:
Anthem Won't Slash Pay for Modifier 25
Question: When will Anthem start cutting its modifier 25 payment by 50 percent? We've hear... Read more
Reader Question:
Prep Now for New Medicare Cards
Question: Our MAC just told us that patients will be bringing in new Medicare cards starti... Read more
CPT® 2018:
Here's How to Report These New GI Codes
From GI anesthesiology to abdominal x-rays, we've got the tips for you. January and Febru... Read more
Can You Solve These GI Diagnosis Coding Puzzles?
Determine whether you know the right ICD-10 codes for these scenarios. You may find it fr... Read more
CMS Offers Big Change to Students' E/M Documentation Rules
New policy will alleviate "double documentation" issues for teaching physicians. If your ... Read more
You Be the Expert:
Can You Answer This Colonoscopy Coding Question?
Question: We saw a Medicare patient for a screening colonoscopy, and the gastroenterologis... Read more
Reader Question:
Get the Scoop on Prolonged Service Coding
Question: Our office manager said that time spent on E/M services, whether face-to-face or... Read more
Reader Question:
Check Payer Policies Before Filing Appeals
Question: We performed imaging for a patient who had a complaint of abdominal pain, and we... Read more
Reader Question:
Look to the 'K' Code Series for Intussusception
Question: Our gastroenterologist recently evaluated a two-year-old male patient who was br... Read more
You Be the Coder:
When Can You Report 99221 and 99238 Together?
Question: Can we bill 99221 and 99238 on the same day under any circumstances? For example... Read more
Part B Errors:
CMS: Upper GI Endoscopy Represented $36 Million in Improper Payments Last Year
Gastroenterologists also saw high error rates for subsequent hospital visits. Gastroenter... Read more
ICD-10 Coding:
Can You Code These 3 Rare GI Conditions?
You may have to skip around the ICD-10 manual to code them all. Gastroenterology coders a... Read more
E/M Coding:
5 Best Practices When Reporting 99211
Nurse visits happen almost every day - but are you billing them correctly? Having a nurse... Read more
Reader Question:
CMS Offers New Guidance Warning Against Texted Orders
Question: We are hearing conflicting advice on whether it's okay for the gastroenterologis... Read more
Reader Question:
Code This Hernia Repair
Question: Our patient was receiving treatment for GERD but saw no improvement from medicat... Read more
Reader Question:
Keep Excludes1 Note in Mind for Dyspepsia
Question: How should we report a diagnosis of indigestion along with heartburn? Supercode... Read more
Reader Question:
Know How to Prove Necessity for Modifier 25
Question: Our claim for an E/M and a procedure was audited and then the payer wanted money... Read more
You Be the Coder:
Code Definitive Dx, When Known
Question: Often, the physician will list several symptoms and signs that the patient is ex... Read more
Expand Your 'Z' Code Knowledge Beyond Z12.11
These codes can come in handy in myriad situations. Most gastroenterology coders are very... Read more
E/M Mythbuster:
Solidify Your E/M Coding Skills With 4 Essential Tips
Hint: Can SOCRATES help shore up your E/M claims? As most coders know, a history of prese... Read more
Clip and Save:
Evaluate What Z Codes Can Do for You
Z codes are your keys to documenting chronic conditions, screenings or underlying physical... Read more
Electronic Health Records:
New Year, New EHR Processes?
These 7 tips could lead you to additional income. If your practice sees a disconnect betw... Read more
You Be the Expert:
"K" Series Could Be Your Best Bet for GERD
Question: A new patient presented with a complaint of heartburn. The provider took a probl... Read more
Reader Question:
RACs Are Looking at This Issue Now
Question: We haven't been keeping up with what the recovery audit contractors (RACs) are r... Read more
Reader Question:
Know What This CCI Indicator Means
Question: I looked up Correct Coding Initiative (CCI) edits for 99221 and 99212, and I saw... Read more
Upper GI Coding:
4 FAQs Help Guide Your Upper GI Coding Choices
Determine where the scope went to pinpoint the right code. Coding Upper GI procedures can... Read more
GI Coding Quiz:
Know How to Report H. Pylori Tests? Take This Quiz to Find Out
Test your knowledge of coding for breath tests and other investigative services. Your gas... Read more
Claim Submissions:
10 Tips Help You Log A Perfect Claim Acceptance Rate
Did you know that Part B MACs have a favorite font for your claim form entries? Gastroent... Read more
You Be the Expert:
Nail Down Specific Code for Non-Specific Pain
Question: A new patient reported to our office complaining of pain in his lower abdomen. A... Read more
Reader Question:
Get Specific When Selecting Polyp Dx
Question: Our gastroenterologist documented a polyp removal but we aren't sure how to... Read more