Advanced Search

Gastroenterology Coding Alert

Acceptance of New Endoscopy Codes Will Increase Reimbursement
" CPT 2001 includes 14 new gastrointestinal endoscopy codes and several code revisi... Read more
Local Payer Determines Observation/Inpatient Payment
Effective Jan. 1, 2001, Medicare will revise its payment policy for observation and inpati... Read more
Reader Question:
Obtaining the RVU
Question: You have mentioned some book about RVUs in the past couple of newsletters. What ... Read more
Reader Question:
Endoscopy Code Bundling
Question: When reporting 43260 and 43239 at the same time, should I attach modifier -51 or... Read more
You Be the Coder:
J-Tube
Question: What code should I use to bill the percutaneous endoscopic placement of a jejuno... Read more
ERCPs:
Report Stone Removal, Destruction and Sphincterotomy to Optimize Reimbursement
"Gastroenterologists often fail to report all the services performed while extracti... Read more
Understand Carrier Policy on E/M with Open Endoscopy
While there are situations where it is appropriate to bill an evaluation and management (E... Read more
Reader Question:
PEG Tube Placement
Question: When we do a percutaneous gastrostomy (PEG) tube placement, the gastroenterologi... Read more
Reader Question:
Diarrhea and Functional Diarrhea
Question: What is the difference between 564.5, which is a covered diagnosis code for a co... Read more
Reader Question:
Clarification: Stent Removal and Replacement
Question: In the article Optimize Reimbursement for ERCPs on page 43 of the June 2000 Gast... Read more
You Be the Coder:
Coding for Replacement of Mic-Key Button
Question: One of our gastroenterologists replaced a gastrostomy tube with a Mic-Key butt... Read more
Distinguish Between High-risk Screening and Diagnostic Colonoscopies to Improve Payment
As Medicares colorectal screening benefits become more widely publicized, primary care phy... Read more
Control of Care Determines Who Can Bill for Consultation
Nearly a year after Medicare tried to clarify its definition of consultations, many gastro... Read more
News Brief:
HCFA Recalls Black Box Edits
For the past two years, the Health Care Financing Administration (HCFA) used both publishe... Read more
Reader Question:
Saline Injection
Question: Which code should be used to report an injection of saline into a polyp during a... Read more
Reader Question:
Helicobacter Pylori Stool Test
Question: What CPT code do we use to report a Helicobacter pylori stool test? Will Medicar... Read more
You Be the Coder:
EGD and AVM
Question: How should we report an esophagogastroduodenoscopy (EGD) and the cauterization... Read more
Use Modifier -53 or -52 to Improve Reimbursement for Incomplete Endoscopies
When an endoscopic procedure is discontinued, gastroenterologists should be able to receiv... Read more
Get the Best Possible Pay Up For Hemorrhoid Removal
Coding and reimbursement for the removal of hemorrhoids done in combination with an endosc... Read more
Amount, Complexity of Data Reviewed Bolsters E/M Payment
Gastroenterologists often overlook the amount and complexity of data reviewed during a pat... Read more
Reader Question:
Contrast Barium Enema
Question: Will Medicare pay for a screeningcontrast barium enema as an alternative to a fl... Read more
You Be the Coder:
Botox Injections for Anal Fissures
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Esophageal Dilations:
Optimize Payment by Knowing When to Bill for Endoscopy, Fluoroscopy and Manipulation
Because there are many different ways that a gastroenterologist can dilate an esophagus,... Read more
Get Paid For PA Supervised By Gastroenterologist
The Balanced Budget Act, which was signed into law in August 1997, removed many of the res... Read more
Use 1995 or 1997 Guidelines to Get Payment for E/M Services
Just when many gastroenterologists had gotten accustomed to performing the more detailed e... Read more
Reader Question:
Principle Diagnosis
Question: Can you use possible, probable or rule-out diagnosis codes as the principle diag... Read more
Reader Question:
Gastric Tube Removal
Question: How do you report when a gastric tube is removed in the gastroenterologists offi... Read more
You Be the Coder:
New vs. Established Patient
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Method of Insertion or Removal Determines Amount of Payment for PEG Tube Procedures
Nugget: Code the insertion or removal of PEG tubes based on whether they were placed endos... Read more
Get Reimbursed for Colonoscopies-through-Stoma
Nugget: Gastroenterologists should indicate procedures done through stoma or done through ... Read more
Documentation/Patient Forms Determine E/M Reimbursement
Nugget: The four levels of history problem-focused, expanded problem-focused, detailed an... Read more
Medicare to Focus Audits on Codes 99214 and 99233
The need for proper documentation of evaluation and management (E/M) services was undersco... Read more
Reader Questions:
Liver Biopsy
Question: Two gastroenterologists in our practice use different codes to report a liver bi... Read more
You Be the Coder:
Screening Tests
Question: Does Medicare cover screening tests for prostate cancer? If so, what codes do we... Read more
Maximize Reimbursement for Esophageal Acid Reflux Tests
Patients needing 24-hour pH monitoring of esophageal acid reflux used to be referred to es... Read more
Optimize Reimbursement for ERCPs
When coding for an endoscopic retrograde cholangiopancreatography (ERCP), gastroenterologi... Read more
Re-evaluate Use of 99211 to Reduce Medicare Scrutiny
Gastroenterology practices should avoid billing for a significant number of level-one esta... Read more
Reader Question:
Anoscopy During Office Visit
Question: When an anoscopy (46600) is performed during an office visit, can the office vis... Read more
Reader Question:
Neoplasms
Question: At a coding conference I attended recently, there was a debate in one of the se... Read more
Reader Question:
Hepatitis Vaccines
Question: Our practice treats many patients with hepatitis B and C. One of our doctors rec... Read more
You Be the Coder:
CLOtest
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Optimize Billing for Three or More Endoscopic Procedures Performed on the Same Day
Gastroenterologists may be familiar with how to code for two endoscopic procedures done on... Read more
Ensure Proper Reimbursement for H.pylori Breath Tests
Two CPT coding changes in as many years have made it difficult for gastroenterologists to ... Read more
Code E/M Visit to Documentation to Increase Reimbursement
Gastroenterologists may be losing a significant amount of revenue by underbilling their co... Read more
Reader Question:
Hot Snare Technique
Question: Should a hot snare procedure be classified as a hot biopsy or snare technique? S... Read more
Reader Question:
Failed Colonoscopy
Question: What constitutes a failed colonoscopy?Sue SchuchartGastroenterology Associates, ... Read more
You Be the Coder:
Decompression Performed With Colonoscopy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Treatment of Crohns Disease With Remicade Faces Coding and Coverage Challenges
Many gastroenterologists have added the new drug Remicade (infliximab) to their repertoire... Read more
Documentation Key to Optimize Billing for Endoscopic Ultrasound
Endoscopic ultrasound is one of several gastrointestinal procedures for which there may ... Read more
Code All Photodynamic Therapy Services for Maximum Pay Up
Photodynamic therapy (PDT) used in conjunction with the drug Photofrin (porfimer sodium) i... Read more
Clarification:
Change in Patient Status Allows For Billing More Than One E/M
In the March Gastroenterology Coding Alert article Initial Hospital Care Codes: Documentat... Read more
Reader Question:
Cold Forceps Biopsy
Question: The coding controversy regarding the use of cold biopsy forceps to remove polyps... Read more
Reader Question:
Modifier -22
Question: Is there a specific quantity (liters) or time increment that must be met in orde... Read more
You Be the Coder:
Two Upper GI Endoscopies
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Get Paid for Botox Injections to Treat Achalasia
Although many gastroenterologists use injections of botulinum toxin type A to treat achala... Read more
Multiple Procedures:
Increase Reimbursement With Correct Modifiers and ICD-9 Codes
Billing for more than one endoscopic procedure performed during the same session can be co... Read more
Initial Hospital Care Codes:
Documentation and Decision-Making Key to Correct Coding
Gastroenterologists frequently see patients in an emergency room, office or other outpati... Read more
Transfer of Care Key to Optimizing Pay Up for Referrals
Patients often are referred to gastroenterologists by other physicians in their practice. ... Read more
Reader Question:
Gastrostomy Tubes
Question: We want to provide the service of manually replacing (not with a scope) gastrost... Read more
You Be the Coder:
Self-injection Instruction
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Use of Prolonged Service Codes Can Significantly Increase E/M Reimbursement
Gastroenterologists who are not using prolonged service codes when they spend an extended ... Read more
Revised Critical Care Codes Accepted by Medicare
The Health Care Financing Administration (HCFA) and CPT often have different definitions t... Read more
Use of Cold Biopsy Forceps Causes Coding Controversy
Because the CPT does not specifically use the phrase cold forceps or cold biopsy forceps i... Read more
Reader Question:
Ileoscopy With Balloon Dilation
Question: What codes can we use for an ileoscopy through a stoma with balloon dilation? Ro... Read more
Reader Question:
Conscious Sedation as Anesthesia
Question: Some insurance companies will reimburse for conscious sedation as part of the an... Read more
You Be the Coder:
Codes for Administering Injections
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Billing Second Opinions as Confirmatory Consults Can Increase Reimbursement
Gastroenterologists often bill for new or established patient office visits (99201-99215) ... Read more
Getting Private Payers to Reimburse for India Ink Tattooing
Gastroenterologists often use India ink tattooing to mark lesions for easy identification,... Read more
Get Reimbursed for Select Surgical Supplies and Drugs
As a general rule, Medicare does not provide additional reimbursement for supplies or serv... Read more
Choosing Correct ICD-9 Codes For Colorectal Cancer Screenings
Billing colorectal cancer screenings for asymptomatic patients can be confusing for many... Read more
Reader Question:
Conscious Sedation
Question: Will Medicare pay for conscious sedation for colonoscopies and esophagogastroduo... Read more
Reader Question:
Injection Education
Question: I work as a clinical nursing specialist in the endoscopy department of a communi... Read more
You Be the Coder:
Rectal Endoscopic Ultrasound
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Available Years:  2000  1999