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Gastroenterology Coding Alert

CPT 2007 UPDATE ~ You Have a New PillCam Code to Use Solely for the Esophagus
Bonus: Find out which gastro code CPT 2007 crossed out Although you only have one CPT 200... Read more
Make Sure You Know How to Determine New-vs.-Established Patients in 2007
Even if the patient has been to your office before, she might be new The responsibility o... Read more
Watch for 'Family Ties' When Reporting Same-Day Scopes
Remember the multiple-scope rule when coding, checking reimbursement If you-re reporting ... Read more
CORRECTION ~ E/M
In the October 2006 Gastroenterology Coding Alert article -3 Tips Are Your Key to Decipher... Read more
READER QUESTION ~ Choose Endoscopy-With-Ablation Code Wisely
Question: Does a code exist for this procedure: -small bowel enteroscopy with ablation of ... Read more
READER QUESTION ~ Find Out How to Report Hepatitis Injections
Question: How should I code hepatitis A and hepatitis B injections? We have the medication... Read more
READER QUESTION ~ Get Your Gastric Adenoma Answer Here
Question: What is gastric adenoma, and how should I code it?Maine Subscriber Answer: Gast... Read more
READER QUESTION ~ Sharing Consults Not an Option
Question: I recently participated in a teleconference covering 2006 changes for Medicare r... Read more
READER QUESTION ~ Count Reviewing Records as Part of E/M
Question: My physician wants to bill for the time she spends reviewing medical records fro... Read more
READER QUESTION ~ When GI Biopsies and Removes Polyp, Use 1 Code
Question: During a colonoscopy within the sigmoid colon, the gastroenterologist biopsied a... Read more
READER QUESTION ~ Stop Counting Gastro's Consults
Question: How often can we report consult codes for the same patient? We saw a patient in ... Read more
YOU BE THE CODER ~ Solve This pH Study Denial Mystery
Question: We-re trying to get authorization from Aetna for the 24-hour pH study. We-ve use... Read more
CPT 2007 Update:
Fixate on 82270 Only -- Not G0107 -- for Your Screening FOBT Claims
Here's why you should avoid reporting 82270 x 3 CPT 2007 promises the deletion of fecal o... Read more
Modifier 52 Mishaps Could Mean Lost Reimbursement
Find out what your documentation should include Every time you consider appending modifie... Read more
NCCI 12.3 Update:
Learn This ED Visit and Critical Care Edit Now
Find out whether this edit will allow a modifier Good news: Gastroenterology escaped the ... Read more
Reader Question ~ Break Down Procedure Into Endoscope and PDT
Question: My op notes indicate the gastroenterologist performed 75 minutes of photodynamic... Read more
Reader Question ~ Avoid 799.9 When Patient Has Identifiable Symptom
Question: When an asymptomatic patient comes to the office for his checkup prior to a scre... Read more
Reader Question ~ To Qualify, You Need 2 Out of 3 Components
Question: I have a claim with the following info: Established patient reports with vomitin... Read more
Reader Question ~ Verify This V Code for Screening Colonoscopy
Question: If a Medicare patient is having a colonoscopy due to family history of colon can... Read more
Reader Question ~ Use Caution With Observation Codes
Question: My gastroenterologist saw a patient on Thursday night while he was the attending... Read more
Reader Question ~ Zone In on Hemorrhoid Removal Strategies
Question: I-m confused about how to report hemorrhoid removal. How should I code this?Cali... Read more
Reader Question ~ Type of Payer Makes the Difference for Remicade
Question: A non-Medicare patient with Crohn's in an unspecified site comes to our office f... Read more
You Be the Coder ~ Ask 1 Question for Proctosigmoidoscopy Code
Question: Our gastroenterologist removed three polyps using hot biopsy forceps during a pr... Read more
Explore Your 43239 Billing Opportunities When Reporting Multiple EGDs
Learn when you should -- and shouldn't -- use modifier 59When your gastroenterologist perf... Read more
3 Tips Are Your Key To Deciphering 99213 and 99214
Avoid these 2 upcoding mistakesPayers audit 99214 more than any other E/M code, so you nee... Read more
Prevent Precolonoscopy Screening Coding Headaches
A simple checklist may be the answer to all your problems If you-re uncertain whether... Read more
Reader Questions:
Check Out Modifier 78, 79 Basics
Question: A patient had a basic partial colectomy on May 16, which put his global period e... Read more
Reader Questions:
Make Your ABN Known With a Modifier
Question: Is there a modifier I can use to let Medicare know I have an ABN on file?Washing... Read more
Reader Questions:
Use Medicare Site for Quick LCD Search
Question: Where can I go to look up Medicare carriers- local coverage determinations? Also... Read more
Reader Questions:
Report 43219 for Feeding Tube Insertion
Question: The gastroenterologist performed an esophagoscopy and inserted a feeding tube in... Read more
Reader Questions:
Choose From 2 Techniques When Treating Varices
Question: What methods can gastroenterologists use to treat esophageal and gastric varices... Read more
Reader Questions:
Include Prescription Writing in E/M
Question: I heard that there's a code we can bill (and be paid for) to indicate when our p... Read more
You Be the Coder:
'000' Global Days Still Mean Global Period
Question: I-m trying to wrap my head around the new CMS notice about using modifier 25 onl... Read more
Choose the Right Rectal Scope Every Time--Here's How
Don't be confused by how far the scope goes Distinguishing between different scop... Read more
Emergency Department:
Get to the Bottom of ED Coding By Asking 3 Simple Questions
Inpatient or outpatient will affect your choiceDon't be left in a tizzy when your gastroen... Read more
Run Down These 4 Quick Checklists for Perfect Appeals
Follow Medicare's rules for faster appeals processingMaking sure your claims are flawless ... Read more
Take This Colonoscopy and E/M Pop Quiz
Will you choose the right codes?Test your colonoscopy and E/M coding expertise with this t... Read more
Audits:
Be Prompt With RAC Requests--or Face the Consequences
A fast response will pay offYour doctor may be performing some procedures that the Recover... Read more
READER QUESTIONS:
Know Which Modifier Works for 2 Services
Question: We performed an inpatient consultation and decision for esophagogastroduodenosco... Read more
READER QUESTIONS:
Secure Payment for Capsule Endoscopies
Question: We recently started doing capsule endoscopies, but they-re being denied for diag... Read more
READER QUESTIONS:
PEG Tube Replacement Depends on Removal
Question: We just started to do PEG tube replacement and removal in our practice. Which co... Read more
READER QUESTIONS:
Capture EUS Payment
Question: How should we bill for the facility portion of an esophageal ultrasound (EUS) do... Read more
You Be the Coder:
Bill for EGD Dilation and Biopsy
Question: Can we bill both an EGD dilation and biopsy if done at the esophagus? Kan... Read more
Screening vs. Diagnostic Colonoscopies -- CMS Tries to Set the Record Straight
 What to do with no end to the debate in sight Reporting screening colonoscopies tha... Read more
Remember 3 Important Tips When Using Modifier 25
 Watch out: Payer scrutiny is on the rise  A recent CMS memo clarifies modifier... Read more
Prevent Observation Denials By Clearing Up POS Codes
State law may have more to say about this than you think When you-re coding for observati... Read more
Complete Your Crohn's Claims In 3 Easy Steps
Overcome this coding challenge Reporting for Crohn's patients can make your head spin, bu... Read more
Reader Questions:
Don't Code Separately for Decompression
Question: If a physician performs a colon procedure to place a decompression tube, is ther... Read more
Reader Questions:
Remember to Add Modifier 26 for Stent Removal
Question: One of our doctors performed an endoscopic stent removal in the bile duct. I-m n... Read more
Reader Questions:
Use 43450 for Maloney Dilation
Question: Our gastroenterologist performed an endoscopy, and after introducing the scope t... Read more
Reader Questions:
You Don't Need an Additional Code for Brushing
Question: One of our doctors performed an EGD with biopsy and brushing. I know I should us... Read more
Reader Questions:
Endoscopy Includes Moderate Sedation
Question: Can I bill 99144 with an EGD or colonoscopy? I have never billed the conscious s... Read more
Reader Questions:
Prove Gastro Provided Critical Care Before Filing
Question: In the afternoon, our gastroenterologist saw a patient for 30 minutes on the hos... Read more
You Be the Coder:
Report 45381 When There's a Tattoo
Question: If a physician performs a colon procedure and marks a tattoo, is there a separat... Read more
Review G-Tube Replacement Procedure Before Choosing 43760
Radiologic supervision and endoscopic guidance call for different codes Getting to kno... Read more
Medicare Update:
Relax -- CMS Clears Away The Consult Confusion
CMS places the responsibility in the requesting physician's hands Some gastroenterologist... Read more
Safeguard Your Claims With The Highest Degree of Accuracy
Asking just 2 questions can help you get the most specific code Reporting your diagnoses ... Read more
Keep Related Codes Straight With Modifiers 59 and 51
Recognizing separate and multiple procedures is key If you-re only reporting one code whe... Read more
Reader Questions:
You Only Get 1 Shot at Some Codes
Question: My physician isn't satisfied to report 45385 just once if he removes several pol... Read more
Reader Questions:
Use 45380 for Cold Forceps Polyp Removal
Question: Our gastroenterologist performed a colonoscopy and found a sessile polyp in the ... Read more
Reader Questions:
Focus Your Colonoscopy Coding on These 2 Words
Question: When performing a colonoscopy, our gastroenterologist found a miniscule polyp. H... Read more
Reader Questions:
Rely on the Result, Not the Procedure
Question: A Medicare patient came in for a screening. The physician performed a cold biops... Read more
Reader Questions:
Method Doesn't Matter for Control of Bleeding
Question: My doctor has been using an argon laser to control bleeding, whether in the colo... Read more
You Be the Coder:
5 Indicators That Can Point to Diagnostic EGD
Question: I am having trouble recognizing diagnostic upper gastrointestinal endoscopies (E... Read more
Expand Your Hemorrhoidectomy Billing Opportunities -- Here's How
Patient and complaint status may call for additional services In some cases, you can repo... Read more
6 Points You Absolutely Must Know About NCCI
Learn when it's OK to unbundle and increase your reimbursement potential If you-re report... Read more
Get Time on Your Side and Improve the Bottom Line
Increase your E/M by an entire level or more with proper documentation You don't have to ... Read more
Confused by Time-Based E/M Vs. Prolonged Services? Read On
30-minute mark provides a benchmark CPT specifies that if counseling and coordination of ... Read more
Crucial Documentation Tips For Time-Based Services
Content, not just time, should be part of the medical record If you want to be able to co... Read more
Reader Questions:
1 Code Describes Tube Conversion
Question: How do I report a PEG-to-J-tube conversion?Ohio Subscriber Answer: In most case... Read more
Reader Questions:
'After-Hours' Status Could Depend on Payer
Question: A Medicare patient arrived on a Friday when the office was closed. He was concer... Read more
Reader Questions:
Crack the 'NOS' Vs. 'NEC' Code
Question: What do -NEC- and -NOS- mean in diagnosis coding? How should I choose between ... Read more
Reader Questions:
Payer Holds the Cards for 91110 Diagnoses
Question: What are the proper CPT and ICD-9 codes to report for use of the -gut-cam-?Flori... Read more
Reader Questions:
43771 Might Not Mean What You Think
Question: How should I code for in-office adjustments of gastric lap bands? Can I report 4... Read more
Reader Questions:
Modifier 59 Can Help With Dual Techniques
Question: Can we report EUS (43242) at the same time as EGD with biopsy of the stomach (43... Read more
You Be the Coder:
Is Injection With Removal Separate?
Question: During a colonoscopy, the doctor found a hemorrhaging polyp. To deal with the bl... Read more
4 Surefire Ways to Inject Accuracy Into Your Interferon Coding
NPPs can get paid for teaching patients to self-inject--here's howYou have a number of opt... Read more
Coding 101:
'New' or 'Established' Might Mean More Than You Think
Ask 2 key questions to pick the right code--and the right level--every timeWhen reporting ... Read more
News You Can Use:
Do Polyps Make a Screening Diagnostic? CMS Clarifies
Recent policy statements aren't what they're cracked up to beCMS officials caused some con... Read more
Correction
The December 2005 Gastroenterology Coding Alert included a typographical error on page 96 ... Read more
READER QUESTIONS:
Colonoscopy Counts If You Pass Splenic Flexure
Question: Our doctor attempted a colonoscopy with decompression. He passed the splenic fle... Read more
READER QUESTIONS:
Extent of Use Determines EUS Code
Question: What are the proper codes for endoscopic ultrasound (EUS) during an esophagogast... Read more
READER QUESTIONS:
Reporting Hospital Care per Service? Watch Out
Question: Our gastroenterologist sees a patient on rounds in the morning. The hospital sta... Read more
READER QUESTIONS:
1 Polyp = 1 Method of Removal Only
Question: I have an op report that states, -At the hepatic flexure, a sessile polyp 10 mm ... Read more
You Be the Coder:
What Findings Make a Screening Diagnostic?
Question: How should we report a finding of hemorrhoids during a screening colonoscopy? Wo... Read more
3 Steps Help Handle Hepatitis Case Coding
You can report NPP services for follow-up care Hepatitis patients require ongoing care--f... Read more
Join With Requesting Doctors, Or Lose Out on Consults
You can use a fax-back sheet to help meet new documentation requirements According to a r... Read more
Use This Sheet to Coordinate Your Consult Documentation
New Medicare rules outlined in Medlearn Matters article MM4215 stipulate that both the con... Read more
Make the Change:
CMS Delivers on 96413/96415
You should rely on new chemo codes for Remicade infusions CMS has fulfilled experts- e... Read more
Reader Questions:
HEM Now Counts for Nursing Care
Question: Our gastroenterologist recently performed a readmission assessment for a nursing... Read more
Reader Questions:
If Medicare Includes Supplies, Don't Unbundle
Question: Medicare will not pay separately for a PEG tube (that is, the tube itself, not t... Read more
Reader Questions:
Subsequent Care Describes Same-Stay Follow-Up
Question: One of my doctors provides an initial inpatient consult and then signs off on th... Read more
You Be the Coder:
Does Pre-Existing Condition Negate Screening?
Question: If a patient with a pre-existing diagnosis receives a colonoscopy, should we rep... Read more
If You Haven't Updated Your Esophageal Impedance Coding, Here's What You Must Know
Report all studies lasting more than an hour with 91038Although you should no longer consi... Read more
Don't Let Misconceptions Limit Your E/M Payments
Unrelated problems on the same day could lead to separate E/M servicesIf a patient visits ... Read more
Learn One ICD-9 Coding Rule That Never Fails
You can (and often should) use signs and symptoms as a primary diagnosisHere's a coding ru... Read more
Apply Modifier 26 Like a Pro With This Simple Advice
Who owns the equipment is only part of the story for proper codingUsing modifier 26 in the... Read more
READER QUESTIONS:
Injection Isn't Bundled to Colonoscopy
Question: During colonoscopy, the gastro-enterologist found a polyp in the cecum. He remov... Read more
READER QUESTIONS:
Key Components Distinguish E/M Services
Question: How should I choose between coding a time-based E/M service code or prolonged se... Read more
READER QUESTIONS:
Supervising Physician Should Author POC
Question: I-m confused about physician supervision rules. Specifically, if Dr. Smith devis... Read more
READER QUESTIONS:
Anatomy Is Crucial for Scope Selection
Question: I-m new to GI coding and am having difficulty choosing among various scopes (ano... Read more
READER QUESTIONS:
Family History, Others Constitute 'High Risk'
Question: I am aware that Medicare will pay more frequently for screening colonoscopy for ... Read more
You Be the Coder:
How Should You Report 'Basket Technique'?
Question: During endoscopic retrograde cholangiopancreatography (ERCP), the GI extracted f... Read more
Learn Your GERD Dx Testing Options in 5 Easy Steps
You can report testing and E/M on the same day, with 25 Don't be confused by -ac... Read more
Endoscopy Can Be Separate With GERD Tests
You'll have to supply evidence of necessity for the scopeIf your gastroenterologist perfor... Read more
Distinguish Consults From Transfers of Care--Here's How
Your physician can provide treatment and still claim a consultWhen your gastroenterologist... Read more
Test Your Consult vs. Transfer Of Care Knowledge
You must have the 3 R's to report a consultIf you think you understand the difference betw... Read more
Correction:
Never Bill More Than 1 Unit of 99218-99220 per Stay
The December 2005 Gastroenterology Coding Alert included a typographical error in the... Read more
READER QUESTIONS:
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
READER QUESTIONS:
Code Colonoscopy Through Stoma With 44388
Question: Does CPT contain a code for colonoscopy through the stoma? If the physician perf... Read more
READER QUESTIONS:
Only the Unlisted Procedure Describes Secca
Question: How can we report use of the Secca System to treat several fecally incontinent p... Read more
READER QUESTIONS:
ERCP Bundles Fluoroscopy for Visualization
Question: Can we charge for fluoroscopy separately when the physician performs ERCP in the... Read more
READER QUESTIONS:
Ultrasound Endoscopy Has Its Own Codes
Question: What is EUS and how should I code for it?Ohio Subscriber Answer: EUS is an abbr... Read more
You Be the Coder:
Which Codes Will You Call on for Varices?
Question: What is the proper code to report treatment of esophageal and/or gastric varices... Read more
Remake Your Remicade Reporting in 2006 With New Administration Codes
Medicare may also do away with G codesEditorial changes and a series of new codes mean you... Read more
Make Sure You Know the New Code for In-Office FOBTs
You'll need a minimum of 2 samples to report 82270 Beginning Jan. 1, you-ll no lo... Read more
Medicare Screenings Call for Different FOBT Code
Medicare limits payment to 1 screening every 12 months When the physician orders/perf... Read more
Same-Day Service and Significant E/M Demands 25
Separate documentation must stress the distinct nature of the E/MIf you fail to report a l... Read more
Use This Checklist to Ease Your Modifier 25 Claims
To ease payment for your claims for modifier 25 (Significant, separately identifiable eval... Read more
READER QUESTIONS:
Removal Includes Biopsy
Question: Can I report biopsy ( CPT 45380 ) on the same days as removal (for instance, 453... Read more
READER QUESTIONS:
Written Consult Request Isn't Mandatory
Question: We-ve heard conflicting information about the requirement for a written request ... Read more
READER QUESTIONS:
Incomplete Colonoscopy Coding Depends on Payer
Question: I-ve heard conflicting guidelines on whether to append modifier 52 or modifier 5... Read more
READER QUESTIONS:
Medicine Codes Provide M2A Capsule Code
Question: Which code is correct for -M2A capsule-?North Dakota Subscriber Answer: The M2A... Read more
READER QUESTIONS:
Multiple Removals Might Mean Multiple Codes
Question: Often, the gastroenterologist will remove several polyps via colonoscopy using t... Read more
READER QUESTIONS:
Nonphysician Staff Can Perform History Element
Question: Must the physician take a patient's history, or can a nurse or other nonphysicia... Read more
You Be the Coder:
If You Dislodge a Foreign Body, Is It a Removal?
Question: Can I report biopsy ( CPT 45380 ) on the same days as removal (for instance, 453... Read more
Available Years:  2006  2005  2004  2003  2002  2001  2000  1999