Gastroenterology Coding Alert
CPT Update:
2003 Brings Big Changes to Dilation and Injection Surgery Codes
The answers to your endoscopy coding problems are finally here: New 2003 CPT codes c... Read more
2003 Brings Big Changes to Dilation and Injection Surgery Codes
The answers to your endoscopy coding problems are finally here: New 2003 CPT codes c... Read more
Take the Guesswork Out of Ambulatory Endoscopy Coding
Because coverage and coding guidelines for procedures performed in an ambulatory surgi... Read more
Because coverage and coding guidelines for procedures performed in an ambulatory surgi... Read more
Conscious Sedation in ASCs
Most gastroenterologists use conscious sedation during ambulatory endoscopies but... Read more
Most gastroenterologists use conscious sedation during ambulatory endoscopies but... Read more
News Brief:
OIG Issues Latest Work Plan
The HHS Office of Inspector General has released the work plan for the 2003 fiscal... Read more
OIG Issues Latest Work Plan
The HHS Office of Inspector General has released the work plan for the 2003 fiscal... Read more
Reader Questions:
Properly Diagnose Pouchitis
Question: Is there an ICD-9-CM code for the diagnosis pouchitis? Florida Subscrib... Read more
Properly Diagnose Pouchitis
Question: Is there an ICD-9-CM code for the diagnosis pouchitis? Florida Subscrib... Read more
Reader Questions:
Blind Foley Extractions
Question: How should I bill for a blind Foley extraction of esophageal coins? I though... Read more
Blind Foley Extractions
Question: How should I bill for a blind Foley extraction of esophageal coins? I though... Read more
Reader Questions:
Code Colonoscopies by Technique Used
Question: How should I code for a colonoscopy with biopsies and the removal of a polyp... Read more
Code Colonoscopies by Technique Used
Question: How should I code for a colonoscopy with biopsies and the removal of a polyp... Read more
You Be the Coder:
Get Paid for PDT
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Get Paid for PDT
Test your coding knowledge. Determine how you would code this situation before loo... Read more
New CCI Edits:
Gastroenterologists Expect More Bundling
Although the latest Correct Coding Initiative (CCI) version 8.3 adds several... Read more
Gastroenterologists Expect More Bundling
Although the latest Correct Coding Initiative (CCI) version 8.3 adds several... Read more
Get the Most out of Time Spent on Chronic Hepatitis C Patients
With the number of hepatitis C patients growing at an astounding rate, your pr... Read more
With the number of hepatitis C patients growing at an astounding rate, your pr... Read more
Get Paid for PA Services Under Direct Supervision
Since chronic hepatitis patients often require long-term follow-up treatment from ph... Read more
Since chronic hepatitis patients often require long-term follow-up treatment from ph... Read more
READER QUESTION:
Gastroccult Coding
Question: What is the CPT code for Gastroccult (new waived test for detecting ... Read more
Gastroccult Coding
Question: What is the CPT code for Gastroccult (new waived test for detecting ... Read more
READER QUESTION:
Malignant Versus Benign Neoplasms
Question: Which code should be used for cancer in a polyp? When is this consider... Read more
Malignant Versus Benign Neoplasms
Question: Which code should be used for cancer in a polyp? When is this consider... Read more
READER QUESTION:
Busting Insurance Company Bundles
Question: Some insurance companies bundle surgical codes such as 45380 (Colonosc... Read more
Busting Insurance Company Bundles
Question: Some insurance companies bundle surgical codes such as 45380 (Colonosc... Read more
READER QUESTION:
The Final word on Conscious Sedation
Question: I want to bill conscious sedation. Which code should I use for this, and... Read more
The Final word on Conscious Sedation
Question: I want to bill conscious sedation. Which code should I use for this, and... Read more
READER QUESTION:
Multiple Techniques During a Colonoscopy
Question: My doctor says that during a colono-scopy a polyp is discovered. He "deb... Read more
Multiple Techniques During a Colonoscopy
Question: My doctor says that during a colono-scopy a polyp is discovered. He "deb... Read more
You Be The Coder:
Defining an Incomplete Colonoscopy
Test your coding knowledge. Determine how you would code this situation before... Read more
Defining an Incomplete Colonoscopy
Test your coding knowledge. Determine how you would code this situation before... Read more
Unravel Hemorrhoid Coding With Four Tips
Reporting hemorrhoidectomies performed in conjunction with endoscopies is not always... Read more
Reporting hemorrhoidectomies performed in conjunction with endoscopies is not always... Read more
Know Three Key Elements of Modifier -59
The keys to understanding modifier -59 perhaps the trickiest modifier in the bo... Read more
The keys to understanding modifier -59 perhaps the trickiest modifier in the bo... Read more
Two Distinct Scenarios Shine Light on Modifier -59
Overuse of modifier -59 (Distinct procedural service) raises red flags and invites a... Read more
Overuse of modifier -59 (Distinct procedural service) raises red flags and invites a... Read more
ICD-9 for 2003:
ICD-9 for 2003:
New Diagnoses Codes Leave Gastroenterologists Unaffected Gastroenterologists don't ne... Read more
ICD-9 for 2003:
New Diagnoses Codes Leave Gastroenterologists Unaffected Gastroenterologists don't ne... Read more
Medtronic Now Owns Bravo pH Monitoring System
Endonetics, the medical device company that developed the Bravo pH Monitoring System, ... Read more
Endonetics, the medical device company that developed the Bravo pH Monitoring System, ... Read more
Reader Question:
Flex Sig With Colon Dilation
Question: How should I report a flex sigmoidoscopy with dilation of colon stricture? ... Read more
Flex Sig With Colon Dilation
Question: How should I report a flex sigmoidoscopy with dilation of colon stricture? ... Read more
Reader Question:
In-Hospital Remicade Infusion
Question: When I provide therapy for Crohn's disease patients at the hospital rather t... Read more
In-Hospital Remicade Infusion
Question: When I provide therapy for Crohn's disease patients at the hospital rather t... Read more
Reader Question:
Sigmoidoscopy With Stent Removal
Question: I billed 45332 for sigmoidoscopy with foreign-body removal with diagnosis co... Read more
Sigmoidoscopy With Stent Removal
Question: I billed 45332 for sigmoidoscopy with foreign-body removal with diagnosis co... Read more
Reader Question:
Incomplete Colonoscopy
Question: How should I charge for a colonoscopy when the patient wants to discontinue ... Read more
Incomplete Colonoscopy
Question: How should I charge for a colonoscopy when the patient wants to discontinue ... Read more
You Be the Coder:
Definitive Diagnosis Versus Initial Status
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Definitive Diagnosis Versus Initial Status
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Bravo pH Monitoring System Solves the Burn?
Payment for the new Bravo pH Monitoring System is so tenuous that many coders are prep... Read more
Payment for the new Bravo pH Monitoring System is so tenuous that many coders are prep... Read more
10 Tips to Differentiate Consultations and Referrals
Because consultations reimburse more than referrals, they're a tempting coding opt... Read more
Because consultations reimburse more than referrals, they're a tempting coding opt... Read more
Reader Question:
Consultation Versus Preventive Medicine
Question: When a patient is referred to our physicians for evaluation for a screenin... Read more
Consultation Versus Preventive Medicine
Question: When a patient is referred to our physicians for evaluation for a screenin... Read more
Reader Question:
Colonoscopy With Noncovered Symptoms
Question: How should I code a colonoscopy for a Medicare patient who has symptoms that... Read more
Colonoscopy With Noncovered Symptoms
Question: How should I code a colonoscopy for a Medicare patient who has symptoms that... Read more
Reader Question:
Early Admit
Question: An elderly or handicapped patient is admitted the day before surgery for pre... Read more
Early Admit
Question: An elderly or handicapped patient is admitted the day before surgery for pre... Read more
You Be the Coder:
Biopsy or Snare
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Biopsy or Snare
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Five Steps to EUS Coding Success
Reviewed on May 15, 2015 Payment is down for endoscopic ultrasound procedures performe... Read more
Reviewed on May 15, 2015 Payment is down for endoscopic ultrasound procedures performe... Read more
GAC Notes Eliminate Your EUS Fears
EUS, FNA, radiology! Having trouble keeping those codes straight? Put those numbers ... Read more
EUS, FNA, radiology! Having trouble keeping those codes straight? Put those numbers ... Read more
Master Remicade Infusions With Diagnosis, Dosage, Documentation
Although most insurance plans cover infusion treatment of infliximab (Remicade) fo... Read more
Although most insurance plans cover infusion treatment of infliximab (Remicade) fo... Read more
CCI Update:
Gastroenterologists Emerge Unscathed by Newest Edits
The newest Correct Coding Initiative (CCI) version (8.2) confirms many obvious coding ... Read more
Gastroenterologists Emerge Unscathed by Newest Edits
The newest Correct Coding Initiative (CCI) version (8.2) confirms many obvious coding ... Read more
Reader Question:
Colonoscopy With Dilation
Question: Which CPT code should I assign for a colonic stricture dilatation? The opera... Read more
Colonoscopy With Dilation
Question: Which CPT code should I assign for a colonic stricture dilatation? The opera... Read more
Reader Question:
Sigmoidoscopy and Hemorrhoid Removal
Question: My gastroenterologist performed a sigmoi-doscopy for a patient with rectal b... Read more
Sigmoidoscopy and Hemorrhoid Removal
Question: My gastroenterologist performed a sigmoi-doscopy for a patient with rectal b... Read more
Reader Question:
Repeat Screening Colonoscopy
Question: A Medicare patient who had a screening colonoscopy five years ago came in ... Read more
Repeat Screening Colonoscopy
Question: A Medicare patient who had a screening colonoscopy five years ago came in ... Read more
Reader Question:
Foreign-Body Removal
Question: An EGD was performed. The esophageal lumen was noted to be totally obstructe... Read more
Foreign-Body Removal
Question: An EGD was performed. The esophageal lumen was noted to be totally obstructe... Read more
You Be the Coder:
Small Bowel Endoscopy or EGD
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Small Bowel Endoscopy or EGD
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Break Botox Paralysis With Unlisted-Procedure Code or Carriers Suggestions
Because no CPT code exists for injections of substances into the esophagus, except f... Read more
Because no CPT code exists for injections of substances into the esophagus, except f... Read more
The Demands of Botox:
Freeze Claims That Fail Criteria and Documentation Rules
To receive reimbursement for Botox treatment for achalasia, you must meet the cove... Read more
Freeze Claims That Fail Criteria and Documentation Rules
To receive reimbursement for Botox treatment for achalasia, you must meet the cove... Read more
Dont Let Conscious Sedation Numb Payment Possibilities
Although Medicare does not pay for conscious sedation for colonoscopies, some privat... Read more
Although Medicare does not pay for conscious sedation for colonoscopies, some privat... Read more
Conscious Sedation Defined
Conscious sedation is a relaxed state of consciousness that is achieved by administe... Read more
Conscious sedation is a relaxed state of consciousness that is achieved by administe... Read more
Adhere to CPTs Rules for Conscious Sedation
Regardless of payer, you must meet the criteria CPT sets forth in CPT Assistant July... Read more
Regardless of payer, you must meet the criteria CPT sets forth in CPT Assistant July... Read more
Reader Question:
Biopsy and Removal
Question: I have recently received denials for second procedures using 45385, and 4538... Read more
Biopsy and Removal
Question: I have recently received denials for second procedures using 45385, and 4538... Read more
Reader Question:
Primary Versus Secondary V Codes
Question: When a patient is seen for a follow-up from a liver transplant, I report V42... Read more
Primary Versus Secondary V Codes
Question: When a patient is seen for a follow-up from a liver transplant, I report V42... Read more
Reader Question:
ERCP With Radiologic Interpretation
Question: When my physician performs the radiologic interpretation for an ERCP, should... Read more
ERCP With Radiologic Interpretation
Question: When my physician performs the radiologic interpretation for an ERCP, should... Read more
You Be the Coder:
PEG Removal
Test your coding knowledge. Determine how you would code this situation before looking... Read more
PEG Removal
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Change in Date of Service for Motility Tests Speeds Reimbursement
Getting reimbursed for esophageal manometry and acid reflux studies performed on the s... Read more
Getting reimbursed for esophageal manometry and acid reflux studies performed on the s... Read more
CMS,CPT Differences Hinder Use of Care Plan Oversight Codes
Significant differences between the HCPCS and CPT codes for care plan oversight (CPO... Read more
Significant differences between the HCPCS and CPT codes for care plan oversight (CPO... Read more
News Brief:
CMS Provider Update Now Available
A compilation of recent and upcoming changes to CMS policy is now available online. Co... Read more
CMS Provider Update Now Available
A compilation of recent and upcoming changes to CMS policy is now available online. Co... Read more
Reader Question:
Biopsy of Ileocecal Valve During Screening
Question: A Medicare patient had an average-risk screening colonoscopy. The gastroente... Read more
Biopsy of Ileocecal Valve During Screening
Question: A Medicare patient had an average-risk screening colonoscopy. The gastroente... Read more
Reader Question:
Two Biopsies,Different Sites
Question: While performing an EGD, my gastroen-terologist took a cold forceps biopsy... Read more
Two Biopsies,Different Sites
Question: While performing an EGD, my gastroen-terologist took a cold forceps biopsy... Read more
Reader Question:
Ultrasound Probe for Liver Biopsy,Paracentesis
Question: Our practice recently bought an ultrasound probe to mark liver biopsy a... Read more
Ultrasound Probe for Liver Biopsy,Paracentesis
Question: Our practice recently bought an ultrasound probe to mark liver biopsy a... Read more
Reader Question:
Diagnosis Code for Examining Remainder of Colon
Question: A colonoscopy was performed "to examine the remainder of the colon" on a p... Read more
Diagnosis Code for Examining Remainder of Colon
Question: A colonoscopy was performed "to examine the remainder of the colon" on a p... Read more
Reader Question:
Minnesota Tube to Control Bleeding
Question: An EGD was performed on a patient who presented with hematemesis (vomiting b... Read more
Minnesota Tube to Control Bleeding
Question: An EGD was performed on a patient who presented with hematemesis (vomiting b... Read more
You Be the Coder:
Anemia,Gastritis as Indicators for EGD
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Anemia,Gastritis as Indicators for EGD
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Prescreening E/M with Preoperative Dx Is Controversial but May Get Reimbursed
Some gastroenterologists are now getting reimbursed for an E/M service prior to a scre... Read more
Some gastroenterologists are now getting reimbursed for an E/M service prior to a scre... Read more
Decipher Payment Rules for Cosurgery PEG Placements
Reimbursement for percutaneous gastrostomy (PEG) tube placements performed by two ga... Read more
Reimbursement for percutaneous gastrostomy (PEG) tube placements performed by two ga... Read more
More on Modifiers -62 and -80
According to CPT, modifier -62 (Two surgeons) should be used when "two surgeons work... Read more
According to CPT, modifier -62 (Two surgeons) should be used when "two surgeons work... Read more
News Brief:
EUS,Biopsy and Dilation Codes Targeted in CCI 8.1
Gastroenterologists can no longer bill radiology code 76942 with an esophagoscopy with... Read more
EUS,Biopsy and Dilation Codes Targeted in CCI 8.1
Gastroenterologists can no longer bill radiology code 76942 with an esophagoscopy with... Read more
Reader Question:
Subsequent Care and Discharge on Same Day
Question: Should we bill for both a subsequent hospital-care visit and a hospital disc... Read more
Subsequent Care and Discharge on Same Day
Question: Should we bill for both a subsequent hospital-care visit and a hospital disc... Read more
Reader Question:
Injection Therapy with Papillotomy
Question: How should I report an ERCP (endoscopic retrograde cholangiopancreatograph... Read more
Injection Therapy with Papillotomy
Question: How should I report an ERCP (endoscopic retrograde cholangiopancreatograph... Read more
Reader Question:
Colonoscopy with Tumor Fulguration
Question: Our doctor did a colonoscopy with tumor fulguration of the polyp. He also di... Read more
Colonoscopy with Tumor Fulguration
Question: Our doctor did a colonoscopy with tumor fulguration of the polyp. He also di... Read more
You Be the Coder:
EGD or Enteroscopy?
" Test your coding knowledge. Determine how you would code this situation befo... Read more
EGD or Enteroscopy?
" Test your coding knowledge. Determine how you would code this situation befo... Read more
Report Stretta Procedure and ELGP with New Category III Codes
New medical technologies that do not have an established CPT code, such as the Stretta p... Read more
New medical technologies that do not have an established CPT code, such as the Stretta p... Read more
Choose Diagnosis for Colonic Polyps Based on Key Terms
" To select the correct ICD-9 diagnosis code for a colonic polyp, gastroentero... Read more
" To select the correct ICD-9 diagnosis code for a colonic polyp, gastroentero... Read more
News Brief:
AMA Offers Free CPT, RVU Database
The AMA has a new no-cost service that allows users to look up the definitions of CPT code... Read more
AMA Offers Free CPT, RVU Database
The AMA has a new no-cost service that allows users to look up the definitions of CPT code... Read more
News Brief:
Senate Bill Seeks Payment for Screening Consultations, Visits
A bill recently introduced in the U.S. Senate proposes to improve Medicares colorectal can... Read more
Senate Bill Seeks Payment for Screening Consultations, Visits
A bill recently introduced in the U.S. Senate proposes to improve Medicares colorectal can... Read more
Reader Question:
Are All Referrals Consultations?
Question: My gastroenterologist read an article on the 10 most common errors discovered in... Read more
Are All Referrals Consultations?
Question: My gastroenterologist read an article on the 10 most common errors discovered in... Read more
Reader Question:
Billing Multiple ERCP Procedures
Question: I have a gastroenterologist who did the following five procedures at once: ERCP ... Read more
Billing Multiple ERCP Procedures
Question: I have a gastroenterologist who did the following five procedures at once: ERCP ... Read more
You Be the Coder:
Dx for Camerons Ulcers
Reviewed on May 13, 2015 Question: Which diagnosis code should I use to re... Read more
Dx for Camerons Ulcers
Reviewed on May 13, 2015 Question: Which diagnosis code should I use to re... Read more
Reporting Incomplete ERCP with Modifier -53 Preferred to Billing EGD
Even though an incomplete endoscopic retrograde cholangiopancreatography (ERCP) can ta... Read more
Even though an incomplete endoscopic retrograde cholangiopancreatography (ERCP) can ta... Read more
Procedure and Analysis Determine H. Pylori Reporting
Revisions over the past two years to various CPT codes for H. pylori testing have cr... Read more
Revisions over the past two years to various CPT codes for H. pylori testing have cr... Read more
Reader Question:
Placement of J-Tube
Question: My gastroenterologist did a placement of jejunostomy feeding tube (j-tube) throu... Read more
Placement of J-Tube
Question: My gastroenterologist did a placement of jejunostomy feeding tube (j-tube) throu... Read more
Reader Question:
Hospital Stay with Two Consultations
Question: One of our gastroenterologists consulted a patient in the hospital (9925... Read more
Hospital Stay with Two Consultations
Question: One of our gastroenterologists consulted a patient in the hospital (9925... Read more
Reader Question:
ED Visit or Consultation
Question: Our gastroenterologist saw a patient in the hospital and billed a consultation. ... Read more
ED Visit or Consultation
Question: Our gastroenterologist saw a patient in the hospital and billed a consultation. ... Read more
Reader Question:
Recovery Care for Discontinued Colonoscopy
Question: A patient was admitted to my center for a colonoscopy. Sedation was started, b... Read more
Recovery Care for Discontinued Colonoscopy
Question: A patient was admitted to my center for a colonoscopy. Sedation was started, b... Read more
You Be the Coder:
Two-Provider E/M
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Two-Provider E/M
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Is Modifier -51 No Longer Needed for Multiple Endoscopy Claims?
It was the biggest gastroenterology coding question when should modifier -51 (multipl... Read more
It was the biggest gastroenterology coding question when should modifier -51 (multipl... Read more
Revised Medicare Policy Adds Twist to Observation Codes
Observation care may be the most confusing E/M service for gastroenterologists to bill. ... Read more
Observation care may be the most confusing E/M service for gastroenterologists to bill. ... Read more
Reader Question:
Colorectal Cancer Versus Personal History
Question: When should I use a diagnosis of colorectal cancer versus a diagnosis of his... Read more
Colorectal Cancer Versus Personal History
Question: When should I use a diagnosis of colorectal cancer versus a diagnosis of his... Read more
Reader Question:
Intrapractice Referral
Question: When one of our gastroenterologists refers a patient to another gastroenterologi... Read more
Intrapractice Referral
Question: When one of our gastroenterologists refers a patient to another gastroenterologi... Read more
Reader Question:
Dysphagia with EGD
Question: I received denials for esophagogastroduodenoscopy (EGD) with dilation (43248) ... Read more
Dysphagia with EGD
Question: I received denials for esophagogastroduodenoscopy (EGD) with dilation (43248) ... Read more
You Be the Coder:
Different Physician Discharge
Test your coding knowledge. Determine how you would code this situation before l... Read more
Different Physician Discharge
Test your coding knowledge. Determine how you would code this situation before l... Read more
Lowdown on New M2A Video Capsule:
Three Options for Reporting
Although Given Imaging's M2A Video Capsule System is the hot new technology for diagnosi... Read more
Three Options for Reporting
Although Given Imaging's M2A Video Capsule System is the hot new technology for diagnosi... Read more
Answers to Your Questions on Screening Colonoscopies
Due to recent publicity campaigns touting the benefits of colorectal cancer screenings... Read more
Due to recent publicity campaigns touting the benefits of colorectal cancer screenings... Read more
News Brief:
Medicare Issues Memo on ICD-9 Coding for Tests
CMS recently issued a memo (AB-01-144) clarifying its diagnostic coding guidelines for r... Read more
Medicare Issues Memo on ICD-9 Coding for Tests
CMS recently issued a memo (AB-01-144) clarifying its diagnostic coding guidelines for r... Read more
Free Anthrax Coding Report on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Medicare Payment Rules for 2002
In its annual update of Medicare payment rules and the physician fee schedule database, CM... Read more
In its annual update of Medicare payment rules and the physician fee schedule database, CM... Read more
Reader Question:
Dx for Postpolypectomy Syndrome
Question: Patient has abdominal pain (789.00), fever (780.6), nausea (787.02) and distenti... Read more
Dx for Postpolypectomy Syndrome
Question: Patient has abdominal pain (789.00), fever (780.6), nausea (787.02) and distenti... Read more
Reader Question:
Acute, Chronic and Unspecified Esophagitis
Question: An EGD with biopsy (43239) comes back with a finding of acute and chronic esop... Read more
Acute, Chronic and Unspecified Esophagitis
Question: An EGD with biopsy (43239) comes back with a finding of acute and chronic esop... Read more
You Be the Coder:
Two ERCPs on Same Day
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Two ERCPs on Same Day
Test your coding knowledge. Determine how you would code this situation before loo... Read more