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Gastroenterology Coding Alert

Find out How You Can Avoid This Gastroen¬terologist’s Fate
Texas GI physician was found guilty in $16M fraud scheme. When your gastroenterologist ce... Read more
CPT® Coding:
Finish 2019 With Strong Responses to This Coding Quiz
Challenge yourself — and enter 2020 with a bang. As 2019 comes to a close and we prepar... Read more
Don’t Treat Family Members Until You Read This Billing Advice
Remember: Medicare has special rules when it comes to treating family members. Most medic... Read more
You Be the Coder:
Timing Is Everything When Collecting From Patients
Question: Thank you for your Q&A last month about how front desk staff should be train... Read more
Reader Question:
Polish Your ‘Z’ Code Knowledge
Question: Our insurer is now rejecting claims if they see tertiary diagnoses mentioned in ... Read more
Reader Question:
Avoid Reporting Surgical, Diagnostic Endoscopy Codes Together
Question: Our GI physician performed a sigmoidoscopy for screening purposes. During the pr... Read more
Reader Question:
Look for Definitive Dx Before You Code
Question: Which diagnosis code should we report when the physician performs a colonoscopy ... Read more
Reader Question:
Get the Scoop on Medicare Secondary Payer
Question: Who is the Medicare Secondary Payer? Is that Tricare? Supercoder Subscriber An... Read more
CPT® 2020:
Radiology Changes Abound for Gastroenterology Coders
Look for both new, revised codes effective Jan. 1. Ready for a new hemorrhoidectomy code ... Read more
5 Tips Help You Boost Cash Flow
Master your accounts receivables and bring in more cash. If your GI practice has never ch... Read more
E/M Coding:
Visit Runs Longer Than Usual? Capture Pay With Prolonged Service Codes
Consider 3 tactics to account for extra time. You'll see it happen from time to time – ... Read more
Reader Question:
Know How to Handle Past-Due Balances
Question: A patient with a $60 past-due balance reports to the office for his annual check... Read more
Reader Question:
Look to 76872 for Rectal Ultrasound
Question: How should we code for a rectal endoscopic ultrasound? Mississippi Subscriber ... Read more
Reader Question:
Saline Injection May Not Be Billable
Question: Which code should I use to report an injection of saline into a polyp during a c... Read more
You Be the Coder:
Evaluate pH Testing Codes
Question: A patient complained of severe acidity, coughing, and chest pain for over two mo... Read more
Ablation Coding:
3 Tips Keep Your Ablation Claims Flowing
Remember to keep CCI edits at top of mind when selecting codes. For some specialties, cod... Read more
Gastroenterology Staff Under Fire for Exposing Patient Data
Tech incompatibility was at the root of the breach, staffers say. The more technologicall... Read more
Slash the Odds of Fraud Accusations With 10 Quick Tips
Tip: Follow Medicare's news updates. As emphasized in our article about patient privacy s... Read more
Reader Question:
Standby Service May Not Warrant Pay
Question: Our gastroenterologists sometimes stand by for other physicians in high-risk pro... Read more
Reader Question:
H. Pylori Dx Codes Span the ICD-10 Manual
Question: We often perform H. pylori tests – which diagnosis codes apply to these visits... Read more
Reader Question:
Evaluate Chronic Condition Recording Under E/M Guidelines
Question: When counting E/M history, can we use chronic medical conditions in place of ele... Read more
Reader Question:
Identify the Cirrhosis Diagnosis Code
Question: Our physician saw a 60-year-old male patient who presented with complaints of ab... Read more
Reader Question:
Know Whether Injection Justifies 43255
Question: The gastroenterologist attempted to perform an EGD with biopsy on a bleeding duo... Read more
Reader Question:
Use These Tips for Teaching Physician Services
Question: We currently have a medical student working with us at our clinic. In patient en... Read more
You Be the Coder:
How Should You Code G-Tube Replacement?
Question: An ambulance brought in a middle-aged male with a dislodged G tube from the nurs... Read more
CMS Audits:
Auditors Shine Light on Modifier Use with Discontinued Procedures
If you're a fan of modifiers 73 and 74, find out what RACs are reviewing. Every now and t... Read more
Incision And Drainage:
Differentiate Anal I&D from Rectal I&D Codes
When in doubt, query your providers. When you encounter a chart for anal or rectal incisi... Read more
Patient Privacy:
Are You Familiar with Incidental Disclosures?
6 expert tips help you minimize your disclosure risk. Although the HIPAA laws can be fair... Read more
Reader Question:
Is 99199 for No-Shows?
Question: We report 99199 to payers to bill for no-show patients. We've been doing this fo... Read more
Reader Question:
Is Incident-to On Its Way Out?
Question: We have two physician assistants at our GI practice, but we recently heard that ... Read more
Reader Question:
Is There an Order of Operations for CPT® Codes?
Question: We typically list the code with the highest RVU first on our claims when reporti... Read more
You Be the Coder:
Find out If You Can Carry Over EHR Notes
Question: In your article last month on time-based E/M coding, you mentioned the factors t... Read more
Diagnosis Coding:
Look for New History of Digestive Cancer Codes on Oct. 1
You'll find nearly 400 changes in the new ICD-10 code set. Just when you think your ICD-1... Read more
E/M Coding:
Consider This Your Definitive Time-Based E/M Coding Guide
Expert tips and real-life examples can bring you clarity once and for all. If time is mon... Read more
Prep Now for Big Changes to E/M Codes in 2021
Hint: If you report 99201 frequently, this change will have a massive effect on you. Does... Read more
Reader Question:
Know the Limits When Reporting Balloon Dilation
Question: Our physician performed an EGD on a patient with achalasia, and the notes s... Read more
Reader Question:
Confirm Duodenal Stent Codes
Question: Our gastroenterologist recently placed a duodenal stent during endoscopy. H... Read more
Reader Question:
Know When to Employ the 52 Modifier
Question: I'm coding an ERCP, and the gastroenterologist made numerous attempts with ... Read more
You Be the Coder:
How Should You Report Endoscopic Injections?
Question: Our physician will often inspect the submucosal area during upper and lower GI e... Read more
Hemorrhoid Coding:
4 Tips Help Guide Your Internal Hemorrhoid Coding
Tip: This is the time to thoroughly read the op note. You've heard the old adage “locat... Read more
Performing Endoscopic Ultrasounds With EGD? Tighten up Your Coding With These Tips
Selecting the right imaging codes may be simple – but knowing how to report them isn't. ... Read more
Patient Privacy:
Don’t Let Patient Details Slip When Dealing With Others
Avoid giving away information to other patients. Keeping a HIPAA plan in place and checki... Read more
Reader Question:
Get the Scoop on Coding When Patient Isn’t Present
Question: A patient's husband presented to talk about his wife's colonoscopy results and h... Read more
Reader Question:
Find out What Signs, Symptoms Entail
Question: We have a coder who wants to hold charts when patients don't have definitive dia... Read more
Reader Question:
Some Payers Bundle 99211 Into Specific Services
Question: The gastroenterologist saw a patient with GERD and started her on esomeprazole. ... Read more
You Be the Coder:
Can You Code for India Ink Tattooing?
Question: Our gastroenterologist used India ink to mark two lesions she removed by snare t... Read more
Screening Codes:
Eliminate Pre-Colonoscopy Screening Issues By Learning the Reporting Methods
Understand when E/M codes are your best option. Gastroenterology offices often see patien... Read more
GERD Coding:
Look to the 91010 Range for Your GERD Tests
Don't forget to document other treatments on manometry, pH study claims. When your gastro... Read more
Evaluation Codes:
Let These 3 E/M FAQs Get Your Coding on the Right Track
When it comes to office visits, it's not smart to play it safe. It's easy to focus your c... Read more
Reader Question:
Can You Report Double Dilation?
Question: Our physician performed an endoscopic PEG tube placement that required some extr... Read more
Reader Question:
Consider Date of Service for Acid Reflux Exams
Question: A primary-care physician referred a patient with severe heartburn to one of our ... Read more
Reader Question:
Get to Know Paralytic Ileus Diagnoses
Question: Our gastroenterologist examined a patient and ordered an x-ray of the abdominal ... Read more
You Be the Coder:
Seeking Esophageal Hemorrhage Code?
Question: In ICD-9, we had an option to report esophageal hemorrhage, but we can't find a ... Read more
RAC: Don’t Forget That ASC Services Are Included in Consolidated Billing
Do you know how to handle consolidated billing patient issues? Whether you perform servic... Read more
Get The Lowdown on These Diagnoses Commonly Seen in the ASC
From upper GI to colonoscopy, know which codes to report. Just like when you pe... Read more
Can You Solve These 3 ASC Frequently-Asked Questions?
Hint: Modifier SG could be your friend. Suppose you bill Medicare when your gastroenterol... Read more
Reader Question:
It’s HIPAA-Certified – Should You Trust That?
Question: Our office has purchased encryption software that claims to be “100-percent HI... Read more
Reader Question:
Nail Down Functional Dyspepsia Dx
Question: We recently saw a 55-year-old established male patient with complaints of heartb... Read more
Reader Question:
Get Clarity on Reporting Laryngopharyngitis
Question: Which diagnosis code should I use to report reflux laryngopharyngitis? Supercod... Read more
Reader Question:
Get the Scoop on Prolonged Service Coding
Question: We have a new gastroenterologist who seems very fond of adding prolonged se... Read more
You Be the Coder:
Know the Frequency for Initial Hospital Care
Question: Can you use inpatient initial care codes 99221-99223 more than once in the same ... Read more
G-Tube Coding:
Master These G-Tube FAQs
Replacing, removing, or inserting: Get the scoop on coding these services. GI patients of... Read more
Celiac Coding:
Seeing Celiac Patients? Keep Track of These Important Factors
Visits go beyond finding the right dx code – get the scoop here. If your gastroenterolo... Read more
Modifiers 101:
Solidify Your Modifier 25 Knowledge With This Quick Primer
Unsure where to start with this ubiquitous modifier? Read this first. Gastroenterology pr... Read more
Reader Question:
Make Sure Time Is on Your Side in Observation Care
Question: I read your recent reader question about same-day admission and discharge for pa... Read more
Reader Question:
MBI Numbers Don’t Contain the Letter ‘O’
Question: We've encountered some slight confusion when accepting the new MBI numbers on pa... Read more
Reader Question:
Look to ICD-10 Guidelines When Specificity Is in Question
Question: One of our gastroenterologists wants to see in writing where she has to document... Read more
You Be the Coder:
Differentiate Breath Test From Biopsy With H. Pylori Testing
Question: How do we code for H. pylori tests? SuperCoder subscriber Answer: The answer t... Read more
Hemmorrhoid Coding:
Can You Answer These 3 Hemorrhoid Visit FAQs?
Hint: Know the difference between first- and second-degree hemorrhoids. In some cases, co... Read more
CCI Edits:
CMS Transmittal Revision Clarifies When Modifier 59 Applies to NCCI Edits
Let these facts help guide your modifier usage. If the modifier 59 coding rules seem to g... Read more
Is Your GI Practice at Risk of an Audit?
Check these benchmarks to get the scoop. Physician practices are increasingly in the spot... Read more
These Are the Big Five Focus Areas
GI coders should get to know five main areas involved in provider audits: E/M  Cod... Read more
Reader Question:
Colon Resection With Hernia Involvement
Question: Our GI surgeon performed a laparoscopic partial colon resection with anastomosis... Read more
Reader Question:
Find out How to Handle New Physician’s Billing Info
Question: A new physician started at our GI practice, but he hasn't received his insurance... Read more
You Be the Coder:
K56 Code Family Gets Very Specific
Question: I'm used to certain basic diagnoses that we face all the time, like intestinal o... Read more
Part B Reimbursement:
CMS: Gastroenterologists Logged $79 Million in Improper Part B Payments
Plus: Upper GI procedures were a source of problems. With so many compliance facts and re... Read more
Know The Coding Errors That CMS Evaluated
CMS identified $31.6 billion in total improper payments among providers during 2018, and b... Read more
ICD-10 Coding:
Check These Answers to Your 4 Top Signs/Symptoms Questions
Know which key phrases to seek in your physician's documentation. Whether you're new to G... Read more
Using Co-Surgeon for PEG Tube? Consider Modifier 62
Hint: Modifier 80 is not always your best bet. When your gastroenterologist works with an... Read more
Reader Question:
Evaluate Email Coding Options
Question: What's the best way to document email exchanges between a patient's guardian and... Read more
Reader Question:
Confirm Status for Same Day Admit, Discharge
Question: One of our physicians admitted a patient to the hospital at 11:30 a.m., and late... Read more
You Be the Coder:
Check Ordering Dx for Screening FOBT
Question: How do we know whether to report a screening or diagnostic code for a fecal occu... Read more
Recovery Audit Contractors:
RACs Scrutinize Surgical, Diagnostic Endoscopies at Same Session
Watch your endoscopic coding to stay off auditors' radar screens. You may think your gast... Read more
2019 Payment:
CMS Offers Reprieve from Big E/M Changes
Keep an eye on the upcoming changes, however. GI practices have been keeping a close eye ... Read more
Looking Ahead:
Here's What to Expect in 2021
Although CMS won't be instituting big changes to E/M coding and documentation when the cal... Read more
Patient Privacy:
Could Enteral Feeding Device Data Get Hacked?
Tip: Keep medical devices off the network if possible. You've tightened up your HIPAA pro... Read more
Reader Question:
What's the 411 on Modifier GT?
Question: I heard that there was an update about modifier GT but don't understand it.... Read more
Reader Question:
Workers' Comp for GI Practice
Question: A 66-year-old patient presented to our gastroenterology practice for evalua... Read more
You Be the Coder:
Know the Documentation Rules When Coding Based on Time
Question: Thank you for your article last month about coding E/M visits based on time... Read more