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Gastroenterology Coding Alert

CPT 2005 Expands to Include New Esophageal Reflux Test Codes
Yellow cover is just the beginning of changes Starting in January, gastro coders should t... Read more
CPT Inflates New Balloon Distention Code
Catheter test aims to pinpoint chest pain The latest version of the CPT manual will make ... Read more
CPT Expands Breath Hydrogen Test Parameters
But H. pylori scans will still have separate codes While additions and deletions of codes... Read more
Knowing Coding Variances Keys PEG Payments
 If a carrier wants modifier -80 on a PEG placement claim, will you be ready? One th... Read more
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CPT 2005 Changes to Note
Post in your office as a reminder of new codesIf you're worried about what havoc the new C... Read more
Untangle Admissions From Office Visits:
4 Scenarios Show You the Way
Get the pay you deserve for 2-day services If you want to earn your fair share of reimbur... Read more
You Be the Expert:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a patient whe... Read more
Here's How to Code Outpatient-to-Inpatient Encounters
Clip and save your combination E/M service chart If you're not sure what to report for ho... Read more
Reader Questions:
Counseling Must Dominate Visit to Use It as W/M Criterion
Question: Our gastroenterologist saw a patient today for symptoms related to severe stomac... Read more
Reader Questions:
Before Filing, Be Certain Gastro Provided Critical Care
Question: In the afternoon, our gastroenterologist saw a patient for 30 minutes on the hos... Read more
Reader Question:
Same-Day Discharge? Report the 99234 Series
Question: We kept a patient in the hospital overnight for observation and decided the next... Read more
You Be the Coder:
Do Multiple Polyps Mean Multiple Removal Codes?
Question: Our office has not one, but two, coding questions about removing polyps via colo... Read more
Knowing Internal or External Site Takes the Pain Out of Hemorrhoid Coding
Report 46221 only once for rubber banding regardless of the number of ligationsWhen you re... Read more
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Use This Hemorrhoid Coding Quick Key
It's a tough subject, but hemorrhoid knowledge helps the bottom lineIf you didn't know tha... Read more
Quick Quiz:
Get Hip to New Codes, Square Your Office With CPT 2005
Another year, another Stretta code - but which one's the right one? It's official: The Am... Read more
Reader Question:
Varied Dates of Service Make Swell Peritoneocentesis Claims
Question: The gastroenterologist performed peritoneocentesis on a patient to drain fluid f... Read more
Reader Question:
Pair of ICD-9 Codes Proves Colonoscopy Necessity
Question: A patient complaining of rectal pain reported to the office. The gastroenterolog... Read more
Reader Question:
ERCP Getting Complicated? Dial 43269
Question: The physician performed an endoscopic retrograde cholangiopancreatography (ERCP)... Read more
Reader Question:
Code Combo Is Key to FluMist Payment
Question: We are one of the few gastroenterology offices in our area administering the Flu... Read more
You Be the Coder:
Choose Correct Codes for Endoscopic PDT
Question: Our gastroenterologist performed photodynamic therapy (PDT) for one hour on a pa... Read more
EUS, Fine Needle Colonoscopy Codes to Land in 2005
Stretta also straps down permanent code in January If reporting the Stretta procedure is ... Read more
Start Paper Trail Early for Modifier -25 Claims
Documentation must prove significant, separate E/M for reimbursement Did you know that wh... Read more
New Reflux Test Codes Coming
Specific prolonged reading code will help focus claims In addition to the new colonoscopy... Read more
Let These 3 Rules Be Your Modifer -25 Guide
Unsure about your claim? Contact the carrier There are certain situations in which nearly... Read more
READER QUESTION:
ERCP Packages Bundle Fluoroscopy
Question: Last week, one of the physicians in our practice performed a diagnostic endoscop... Read more
READER QUESTION:
Use Modifier -78 for Post-Op 'Complications'
Question: Our gastroenterologist performed a rubber- band ligation on a patient with hemor... Read more
READER QUESTION:
Find Latest NCCI Edits Online
Question: Are the latest National Correct Coding Initiative (NCCI) edits out yet, and if s... Read more
READER QUESTION:
Get Your Gastro Paid for H. Pylori Analysis
Question: Our gastroenterologist performs tests for H. pylori using a C-14 breath analysis... Read more
READER QUESTION:
Determine Global Period Before Reporting Consult
Question: A gastroenterologist in our office met an established patient at the hospital fo... Read more
You Be the Coder:
When Do Services Constitute Separate E/M?
Question: Our office treats several hepatitis patients who come into the office for interf... Read more
Coding Medicare Screening Services? Don't Forget V Codes
Code makes colorectal cancer screening claims rock-solid If you aren't reporting V codes ... Read more
Don't Let Payer KO Your Conscious Sedation Claim
Some insurers will pay separate conscious sedation codes It's a fact: When the gastroente... Read more
Note Every Detail to Ensure Sedation Claim Success
If you can't prove medical necessity, sedation payment is unlikely Getting separately re... Read more
Coding Clarification:
Sigmoidoscopy Code and EGD
In the August 2004 issue of Gastroenterology Coding Alert, the article "Must-Know Tips f... Read more
News You Can Use:
Get Ready for Winter Rush of New CPT Codes
Despite loss of grace period, AMA won't release codes any sooner Gastroenterology ... Read more
Coders Must Provide Last Line Of Documentation Defense
Prove separate site before mailing modifier -59 claim As a coder in a busy gastro office,... Read more
You Be the Expert:
What Is the Most Vital Info on a Claim?
Question: I am trying to come up with a list for my gastroenterologists to follow before t... Read more
Reader Question:
If Doc Just Looks for Problem, Report Diagnostic Colonoscopy
Question: A patient with abdominal distention reported to the office. The gastroenterologi... Read more
Reader Questions:
Stent Placement Code Overrides Dilation
Question: I was coding a transendoscopic stent placement claim. The endoscopic report read... Read more
Reader Questions:
Use Reason When Reporting After-Hours Care
Question: Our normal office hours are 8:30 a.m. to 5:30 p.m. Monday through Friday. Occasi... Read more
Reader Questions:
Control of Bleeding Changes EGD Code Choice
Question: Our physician performed an EGD for a patient with upper gastrointestinal bleedin... Read more
Reader Question:
Show Sloppy Doctor the Dangers of Bad Notes
Question: One of our gastroenterologists is driving the coding department crazy. Each oper... Read more
You Be the Coder:
Can You Report E/M Service for Tube Removal?
Question: My gastroenterologist manually removed a percutaneous gastrostomy (PEG) tube fro... Read more
Find Polyp Removal Methods, Avoid Colonoscopy Coding Quandaries
Gastros can perform ablation, cautery with same technique You have to consider many facto... Read more
Must-Know Tips for Teaching Modifiers
Veterans recommend grouping modifiers by function for training If you're looking for a qu... Read more
News You Can Use:
Need Some Help? AAPC Offers Loads of Workshops
Seminars available for all coding levels If you're looking for some more training in gast... Read more
Reader Question:
Use Mod -32 to Help Carriers Streamline Claims
Question: Our gastroenterologist spends a lot of time on confirmatory consultations that... Read more
Reader Question:
No Common Code Yet for Reporting Enteryx
Question: How should we report Enteryx treatments? Washington, D.C., Subscriber Answe... Read more
Reader Question:
V Codes and OSHA Requirements
Question: A nurse in our private gastroenterology office was asked by the doctor to draw... Read more
Reader Question:
Choose Between 2 Codes for EGD With Stricturoplasty Drainage
Question: A patient reported for an upper gastrointestinal endoscopy (EGD) with strictur... Read more
You Be the Coder:
Check With Carrier Before Reporting Botox Injections
Question: My gastroenterologist performed a Botox injection on a patient with achalasia.... Read more
Latest Version of NCCI Tightens Up Several Gastro Codes
Injections are no longer reportable with some EGD procedures When the gastroenterologist ... Read more
ICD-9 Coding:
It's as Easy as 3,4,5
Carry diagnosis codes out to the most specific digit possible When a patient comes in for... Read more
ICD-9 Coding Quick Quiz
ICD-10 is coming soon ... or is it? How many editions of ICD-9 have been published? Take ... Read more
ICD-9 Web Sites of Note
Complete list of ICD-9 codes available online Here is a list of ICD-9-related Web sites. ... Read more
Follow These Steps for ICD-9 Coding Success
Make sure the gastroenterologist approves the codes before filing There's a right way and... Read more
ICD-9 Coding Quick Quiz Answers
Answers to ICD-9 quiz questions 1. d 2. a 3. c 4. d 5. True 6. True  ... Read more
Reader Question:
Use 43219 for Feeding Tube Insertion
Question: The gastroenterologist performed an esophagoscopy and inserted a feeding tube ... Read more
Reader Question:
M2A Capsule Coding No Longer a Pill
Question: Our office just purchased equipment so we can conduct in-office M2A Capsule te... Read more
You Be the Coder:
Same-Day Consults and Procedures
Question: Our gastroenterologist was called to the hospital to consult on a patient who ... Read more
Learn New Codes This Summer to Prevent Autumn Fall
New diagnosis codes are here, and you must start using them in October If a patient repo... Read more
4 Steps Reduce Denials for Teaching Physician Services
Use these techniques to clarify confusing Medicare guidelines You can ensure that your ga... Read more
Reporting Related Codes? Use Mods -59,-51 To Keep Claims Clear
Use mod -59 when coding procedures not normally reporting together When your gastroent... Read more
You Be the Expert:
Check CPT For Mod -51 Exemptions
Question: Do you have to use modifier -51 every time you code a visit where the gastroen... Read more
Reader Question:
Descending Colon Exam Changes Procedure to Sigmoidoscopy
Question: The physician performed a diagnostic exam on a patient with severe stomach pai... Read more
Reader Question:
Proctectomies Proffer Pair of Coding Choices
Question: Our GI surgeon recently performed a complete proctectomy on a patient with con... Read more
Reader Question:
Don't Wait for Labs to Provide Blood Collection ICD-9 Codes
Question: Our office is having trouble with claims when the gastroenterologist collects ... Read more
Reader Question:
Don't Be Surprised if Secca Claim Needs Appeal
Question: Our gastroenterologist has been using the Secca System to treat several fecall... Read more
Reader Question:
Consider 3 Factors When Determining MDM
Question: One of our newer coders filed an erroneous claim recently in which she assigne... Read more
Reader Question:
Contact Carrier Before Filing for Remicade Payment
Question: Our office performs Remicade infusion sessions for our patients with Crohn's d... Read more
Reader Question:
Attach -GY Mod To Expedite Medicare Denials
Question: What is the -GY modifier, and how do you use it? Oregon Subscriber Answer: M... Read more
Reader Question:
Stopping GI Bleed Can Mean 2-Code Colonoscopy Claim
Question: Our gastroenterologist performed a colonoscopy, during which he removed a poly... Read more
You Be the Coder:
Nurse Injections and E/M Services
Question: When a patient comes in for an injection, can we report a separate E/M service... Read more
43235 Is the Key to EGD 'Family' Coding Success
"CMS has upped RVUs for several EGD codes Do you know how frequently biopsies are performe... Read more
CMS Grants RVU Increases to 4 Codes in the 43235 'Family'
Base endoscopy code is worth 7.59 nonfacility RVUs Gastroenterology coders have no choice... Read more
NCCI 10.1 Edits Bundle Manipulations With EGDs
Maloney dilations are no longer separately reportable in some scenarios If you've been re... Read more
Coding Corner:
NCCI Edits Pop Quiz
Can you handle the new edits? Take this quiz to ease your stress over the latest NCCI edi... Read more
Coding Corner:
NCCI Edits Pop Quiz Answers
Answer for Scenario 1: For Medicare, report only 43249 (Upper gastrointestinal endoscopy i... Read more
Reader Question:
Use Modifier -59 for Normally Bundled Codes
Question: Our office is having trouble distinguishing between the proper times to use modi... Read more
Reader Question:
Attach Prolonged Service Codes to E/Ms Only
Question: Our office sees a lot of hepatitis C patients. Last week, an established patient... Read more
Reader Question:
Infection Affects Pouchitis Diagnosis
Question: What is the proper diagnosis code for pouchitis, and is there a different code i... Read more
Reader Question:
PEJ Tube Reporting Dependent on PEG Presence
Question: How should I report the placement of a PEJ tube?Missouri Subscriber Answer: It ... Read more
Reader Question:
Report 1-Duct Visualizations as Full ERCPs
Question: Two weeks ago, the gastroenterologist performed an endoscopic retrograde cholang... Read more
You Be The Coder:
Append Modifier -21 Only to Level-5 E/M Codes
Question: Our gastroenterologist performed a level-three E/M service on a new patient last... Read more
Know Reporting Methods, Lessen Precolonoscopy Screening Madness
Learn multiple ways to report an asymptomatic screening, and you'll be ready no matter wha... Read more
News You Can Use:
Medicare Updates Physician Fee Schedule
CMS makes changes to some surgery indicators, procedure RVUsCMS has sent out the first upd... Read more
Coding 101:
Recognize Critical Care Quickly to Aid Coding Output
Take this 2-part quiz to see if time is on your sideNo one wants to go to the trouble of f... Read more
Reader Question:
Report 1 Code When Polyp Is Biopsied, Removed
Question: During a colonoscopy within the sigmoid colon, a long, loose polyp on a stalk wa... Read more
Reader Question:
Choose From 2 Techniques When Treating Varices
Question: What methods can gastroenterologists use to treat esophageal and gastric varices... Read more
Reader Question:
Use G Codes for Home Healthcare Certification
Question: What codes should we report when we are certifying and recertifying plans of car... Read more
Reader Question:
Sedation Codes Depend on Carrier
Question: A patient with severe upper abdominal pain reported to the office for an endosco... Read more
Reader Question:
Use G Codes for Home Healthcare Certification
Question: What codes should we report when we are certifying and recertifying plans of car... Read more
Know Risk Indicators for Screening Colonoscopy Patients
If you don't know the risk category for patients who receive screening colonoscopies, your... Read more
Use ABNs if You Think Medicare Might Not Pay
Notices are required before billing a patient the remainder of a Medicare billCPT 2004 may... Read more
ABNs:
What to Change, What to Leave Alone
Medicare is specific on allowable alterations to its ABN formWhen it comes to manipulating... Read more
Restructure Appeals With These 6 Steps
Get organized for easier, more productive appeals When your practice receives a denial... Read more
Read EOBs Before Responding to Denials
What 'noncovered service' really means to your office You can't streamline your appeals p... Read more
You Be the Expert:
What Makes a Clean Claim?
Question: We are having problems in our family  practice with the number of claims ... Read more
Reader Question:
Take a Shot at Injection Reimbursement
Question: While one of our gastroenterologists was performing a colonoscopy on an establis... Read more
Reader Question:
Focus PA Efforts and Max Out Payment Potential
Question: In a gastroenterology office, what kinds of services can a physician assistant p... Read more
Reader Question:
Observe 3-Year Rule for Patient Status
Question: Our practice recently hired another gastroenterologist to help our overworked ph... Read more
Reader Question:
File 1 Code for EGD With Stent
Question: What code should I use for an upper gastrointestinal endoscopy (EGD) with a mesh... Read more
Reader Question:
Note Sequence When Coding for Reflux Exams
Question: A primary-care physician referred a patient with severe heartburn to one of our ... Read more
Reader Question:
Bridge the Communication Gap ASAP
Question: The physicians and billers in my office don't practice open communication, and i... Read more
You Be the Coder - Reporting Removal of Multiple Stones
Question: Our gastroenterologist performed an endoscopic retrograde cholangiopancreatograp... Read more
Know the Components of PDT for Dynamic Reimbursement Potential
Photodynamic therapy offers several billable procedures - if you know what to look for In... Read more
8 Ways to Make PDT Coding More Rewarding
Check your claim against this list for maximum PDT payment Are you sure your photodynamic... Read more
Photodynamic Therapy Coding Quiz
Test your knowledge on these PDT-related scenarios Think you know PDT? Take this quiz on ... Read more
2004 Fee Schedule Update:
Physicians Escape 2004 Conversion-Rate Cut
Medicare reform legislation will increase conversion factor by 1.5 percent Right around T... Read more
News You Can Use:
Category II Codes Come to CPT 2004
However, gastro offices won't be affected much As 2004 stretches into its second month, g... Read more
NCCI Edits Bring Bundles to Esophagoscopy Family
Keep abreast of all relevant edits to avoid denials As if gastroenterology professionals ... Read more
Reader Question:
Get Creative, and You May Get Paid for India ink
Question: A patient reported to the office for a colonoscopy, during which the gastroenter... Read more
Reader Question:
Report Intended Procedure With Modifier -53
Question: Our gastroenterologist attempted a colonoscopy on a patient that was discontinue... Read more
Reader Question:
Use Modifier -59 for Multiple Endoscopies
Question: While performing an upper gastrointestinal endoscopy (EGD), the gastroenterologi... Read more
Reader Question:
Double Dilations Don't Always Lead to Double-Coding
Question: Our physician performed an endoscopic PEG placement that required some extra wor... Read more
You Be the Coder:
Return to the OR During Post-Op Period
Question: Our gastroenterologist conducted a partial colectomy with closure of the distal ... Read more
CPT Special Update:
Stretta, Endoscopic Ultrasound Highlight 2004 Coding Changes
Formerly unlisted procedure finds identity in latest CPT book If your office has trouble ... Read more
Three Easy Steps to Complete - and Clean - Crohn's Claims
Crohn's presents a coding challenge From diagnosis to treatment, reporting for Crohn's pa... Read more
Crohn's Disease Coding Quiz
Test your skills on these specific Crohn's  scenarios Now that you've had a crash co... Read more
Want Remicade Reimbursement? Prove Medical Necessity, Watch the Clock
Don't trip when billing infusions Insurance carriers will pay for Remicade infusions for... Read more
Reader Question:
Code Stent Placement With ERCP
Question: One of our doctors performed an ERCP with sphincterotomy, during which she had t... Read more
Reader Question:
Report Some Screenings as Preventive
Question: One week after a preventive visit with his primary-care physician, a patient was... Read more
Reader Question:
Accept Request for Gastro Consults From Many
Question: Who can request a consultation from a gastroenterologist?Kansas Subscriber Answ... Read more
You Be the Coder:
Crack Confounding Flex Sig/Colonoscopy Combo
Question: A patient required both a flexible sigmoidoscopy and a colonoscopy through stoma... Read more
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