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Gastroenterology Coding Alert

Gain $400 or More For 2 Easily Missed ERCP Components
Your MD needs to document these items to report fluoroscopy codesCoding an endoscopic retr... Read more
Capture Modifier 59 Opportunities With 2 Do's
Here's when you'll most often use this modifier in your gastro practice When y... Read more
Have Pregnant GI Patients? Find Out When OB Codes Are the Answer
Test your documentation attentiveness with these ICD-9 examplesSubtle differences in your ... Read more
Clip-'n'-Save:
Have Your Endoscopy Codes At Your Fingertips
Tired of skimming your CPT book for endoscopy codes? Place this handy chart by your desk, ... Read more
Reader Questions:
You Break It, You Fix It, Per CMS
Question: My doctor attempted to do a banding of esophageal varices. He could not put the ... Read more
Reader Questions:
Get a Handle on Gastro Exams and HEENT
Question: When performing a comprehensive gastroenterology examination, which elements (bu... Read more
Reader Questions:
How to Code Anorectal Biopsies
Question: What is an anorectal biopsy, and how should I report it?Kentucky SubscriberAnswe... Read more
Reader Questions:
Ileoscopy With Balloon Dilation? Do This
Question: Which codes can we use for an ileoscopy through a stoma with balloon dilation?Co... Read more
Reader Questions:
Research Varying Rules for EGD/Conscious Sedation
Question: Is separate reimbursement for conscious sedation administered during an upper ga... Read more
Reader Questions:
Intent Will Validate A Diagnostic Colonoscopy
Question: Our gastroenterologist performed a colonoscopy on a patient with abdominal diste... Read more
READER QUESTIONS:
Intent Will Validate A Diagnostic Colonoscopy
Question: Our gastroenterologist performed a colonoscopy on a patient with abdominal dist... Read more
You Be the Coder:
14-hour pH Monitoring? Here's What to Do
Question: We tried to do a 24-hour pH monitoring of a patient's esophageal acid reflux, bu... Read more
Multiple EGDs? Pay Attention to Payer Guidelines and Code Order
Modifier 59 may not be part of every multi-EGD claimTo determine if your gastroenterologis... Read more
ICD-9 Coding:
4 Solutions to Your Riskiest Signs and Symptoms Questions
Watch out for these phrases in your physician's documentationYour first line of ICD-9 codi... Read more
E/M Note Must Stand On Its Own for Mod 25 Claims
Decision to do minor surgery made after an eval qualifies modifier 25Did you know that whe... Read more
Reader Questions:
Tackle 2 Modifiers for a Home Visit
Question: My gastroenterologist performed a home visit on a patient under hospice care (in... Read more
Reader Questions:
Intercept India Ink Denials With This Advice
Question: A patient reported to the office for a colonoscopy, during which the gastroenter... Read more
Reader Questions:
Make the Most of Your Pill Cam Modifier
Question: My gastroenterologist performed a "gut cam" or "pill cam" procedure in an outpat... Read more
You Be the Coder:
How to Report the Latest Endoscopic Technology
Question: My gastroenterologist is looking into the new cholangioscopy/pancreatoscopy syst... Read more
Let Key Phrases Steer Esophageal Impedance, Motility, and pH Test Codes
Need another road sign? Look for tests lasting one hour versus nearly 24Which esophageal f... Read more
Coding Quiz Questions:
Gauge Your Low and High Risk Colonoscopy Coding Skills
Tip: Your frequency guidelines change when the MD discovers a polypDo you think you've got... Read more
Focus on Modifier 52:
When You Should -- and Shouldn't -- 'Reduce' Your Claim
Search your documentation to see if the colonoscopy passed the splenic flexureFind out whe... Read more
Coding Quiz Answers:
Are You an Ace at Low, High Risk Colonoscopy Claims? Find Out
High risk patients younger than 50 require your special attentionYou've taken the colonosc... Read more
CORRECTION:
CORRECTION:
Medicare typically will not cover (or reimburse you for) an E/M service prior to a screeni... Read more
Reader Questions:
Complete ROS Requires Double-Digit Reviews
Question: I have a question about the review of systems (ROS) portion of E/M services. Wha... Read more
Reader Questions:
Master the Modifier 51 Mystery
Question: I am uncertain about when I should use modifier 51? Do some carriers no longer a... Read more
Reader Questions:
Test Reason Can Lead You to FOBT Code
Question: A commercially insured patient with a recent episode of rectal bleeding reports ... Read more
You Be the Coder:
Remedy Your Rectosigmoid Diagnosis Questions
Question: My gastroenterologist removed a polyp from the rectosigmoid area. Which ICD-9 co... Read more
5 Steps Pinpoint Polypectomy Techniques and Prevent Payment Loss
Experts say the defining factor for control of bleeding is clinical situation and diagnosi... Read more
Need Help With H. Pylori Tests? Look to These 4 Coding Options
Here's why you need to use modifier QW for 87077To appropriately report Helicobacter pylor... Read more
Prove Endoscopy Medical Necessity With Right Diagnoses
Heads up: Check with insurer for a complete listYour lower gastrointestinal endoscopy clai... Read more
Reader Questions:
Weigh Your Healed Gastric Ulcer ICD-9 Options
Question: What diagnosis should I use for gastrointestinal endoscopies (EGD, 43235) perf... Read more
Reader Questions:
No Patient There? Don't Expect Payment
Question: Should we bill an office visit (99211-99215) for a consult with a family member ... Read more
Reader Questions:
Zoom In on This PEG Mushroom Basket Procedure
Question: How should I report replacement of a "mushroom basket" for a PEG tube? I can't f... Read more
Reader Questions:
Coordinate Documentation for In-Office Referrals
Question: For a patient interested in taking the M2A capsule to diagnose her small-bowel p... Read more
Reader Questions:
Find Stomach Polyps Personal History Code Here
Question: What is the code for personal history of stomach polyps?New York SubscriberAnswe... Read more
Reader Questions:
Highlight 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 Questions:
Watch Out for 'Multiple' in Code Descriptors
Question: My report says, "rectal polyps with cold biopsy polypectomy" and "random colon b... Read more
Reader Questions:
Weekend Visit Leads to 99050
Question: My gastroenterologist saw a patient in the office on a weekend. How should I rep... Read more
You Be the Coder:
Secure Same-Session Multiple-EGD Coding
Question: Our physician performed two upper gastrointestinal endoscopies (EGDs) on the sam... Read more
ICD-9 Update:
Get a Grip on New GI Tumor, Smear Codes to Catapult Your October Claims Into Success
Great news: You'll soon use more specific dysplasia and hepatitis codesGastroenterology co... Read more
Verify 5 Facts Before Submitting Lower GI Endoscopy Claims
Hint: The type of scope your gastro uses could change the code completely Picking... Read more
Take the Guesswork Out of Coding for Teaching Physicians
Here's which modifier to use for the primary-care exceptionYou can ensure that your gastro... Read more
Reader Questions:
Fight Denials for High-Risk Screening Colonoscopy
Question: We coded a patient's colonoscopy with V12.72 (Personal history of colon polyps) ... Read more
Reader Questions:
Start and Finish Your Modifier Search Here
Question: A patient came in for a colonoscopy, but all we did was set the IV before she ch... Read more
Reader Questions:
New Technology Requires Unlisted-Procedure Code
Question: Which CPT code should I report with the Agilent capsule endoscopy? This is a cap... Read more
Reader Questions:
Focus on the Meaning of 'Obliterate'
Question: What should I use for argon plasma coagulation (APC)? The patient has a GAVE les... Read more
Reader Questions:
Clear Up This Cold Forceps Biopsy Scenario
Question: I have a report that says, "Ileum appeared normal. Cold forceps biopsy taken for... Read more
You Be the Coder:
G-Tube Replacement
Question: My gastroenterologist introduced an endoscope through the mouth and advanced it ... Read more
Think Beyond Modifier 22 for Control-of-Bleeding Cases
Critical care codes can get you payment fasterAlthough your gastroenterologist may justify... Read more
Overturn Arbitrary Gastro Edits With This Expert Advice
Here's what you should ask the medical directorIf your claims have ever come up against ir... Read more
Bolster Hemorrhoid Coding Accuracy Based on Location
Look for the 1 exception to the removal-of-multiple-hemorrhoids ruleIf you didn't know tha... Read more
Apply New ABN Form by Sept. 1
Heads up: These 3 principles remain the sameCMS has unveiled its new advance beneficiary n... Read more
Reader Questions:
Part Peritoneocentesis Sessions on Claims
Question: The gastroenterologist performed peritoneocentesis on a patient to drain fluid f... Read more
Reader Questions:
Reporting Both 45378 and G0105 Spells Trouble
Question: Our gastroenterologist performed a colonoscopy for a rectal bleed on a Medicare ... Read more
Reader Questions:
Find Your Secca Coding Solution Here
Question: How can we report use of the Secca System to treat several fecally incontinent p... Read more
Reader Questions:
Expect More Money From In-Office Procedure
Question: What is the difference between facility and nonfacility relative value units (RV... Read more
Reader Questions:
Maximize Your Multiple Polyp Coding Knowledge
Question: Our office has two coding questions about removing polyps via colonoscopy. Many ... Read more
You Be the Coder:
Hydrogen Tests Can Diagnose Many Conditions
Question: When a gastroenterologist performs a hydrogen breath test, what are some accepta... Read more
Guarantee a Clean Multiple-Endoscopy Claim and Maximize Reimbursement in 3 Simple Steps
Failure to apply this modifier can cost your practice $137Did you know you can report more... Read more
Coding From the Procedure Note:
Eliminate ERCP Errors by Tackling This Example
Tip: A long procedure note does not necessarily mean a bevy of codesYou don't have to feel... Read more
Focus on E/M:
Draw the Line Between Referrals and Consultations
You'll use specific codes for one, regular E/M codes for the other Latest reports from ... Read more
Still Stumped by Consults vs. Referrals? Try This Trick
Coders can also help their consult-identifying cause by thinking of consults as a "circle ... Read more
Reader Questions:
Take This Sigmoidoscopy, E/M Scenario Challenge
Question: A new patient with anal cancer reported to the office for a diagnostic sigmoidos... Read more
Reader Questions:
Bolster Screening Colonoscopies With ICD-9 Codes
Question: A 70-year-old established Medicare patient with regional enteritis of the duoden... Read more
Reader Questions:
Strike These Modifiers When Reporting 82270
Question: I know we're supposed to use 82270 when the patient takes three cards for collec... Read more
Reader Questions:
Pick Apart Aetna's Propofol Stance
Question: I heard that Aetna is discontinuing payment for propofol for endoscopies. Is thi... Read more
Reader Questions:
Question E/M Code for Tube Removal
Question: My gastroenterologist manually removed a percutaneous gastrostomy (PEG) tube fro... Read more
Reader Questions:
Choose the Perfect E/M Code
Question: What E/M code should I code for the following scenario: This established patient... Read more
You Be the Coder:
Evaluate These Esophageal Function Tips
Question: My gastroenterologist's note states, "I inserted an impedance probe affixed to f... Read more
Apply These 3 Expert Tips to Rev Up Your Remicade Reimbursement
Learn how to cope with claims specifying multiple drug infusionsThe bottom line is this --... Read more
Coding From the Op Note:
This Op Note Will Sharpen Your Screening Colonoscopy Skills
Best practice: Order diagnosis codes based on the reason and findingsLearning your colonos... Read more
Pop Quiz:
Here's How to Get GI Modifiers Right Every Time
Tip: Most hemorrhoid procedures will prompt this modifierBrush up on your modifier use by ... Read more
Clarification:
Internalize 2-Year Screening Colonoscopy Rules
Learn how a mistake could significantly affect Medicare patientsIn the 2007, Vol. 10, No. ... Read more
Reader Questions:
Get Specific With Anemia Codes
Question: My gastroenterologist performed an EGD (43235) on a Medicare patient with severe... Read more
Reader Questions:
Gastric Aspiration Calls for 91105
Question: A patient complaining of rectal bleeding reports to the ED. After a level-five E... Read more
Reader Questions:
Hone Your ICD-9 and Modifier Skills
Question: I think that I have a good handle on coding gastroenterology claims, but if I wa... Read more
Reader Questions:
Unravel the 'Different Edits'Mystery
Question: I follow Correct Coding Initiative (CCI) edits, but some carriers don't follow t... Read more
Reader Questions:
Mod 25: Procedure, E/M Don't Have to Be Unrelated
Question: A patient comes in for a consult because of abdominal pain and bloody diarrhea. ... Read more
You Be the Coder:
Zoom In on Cold Biopsy Forceps
Question: I bill a colonoscopy with biopsy using CPT 45380 when my gastroenterologist us... Read more
On the Cutting Edge:
Take the Guesswork Out of Coding CT Colonographies
Here are the indications you must meet to reap 0067T reimbursementChanges may be on the ho... Read more
Cross Out Rule-Out Diagnoses for Picture-Perfect Claims
Do this when a test's results come back negativeIf you want to start 2008 right, adhere to... Read more
Hold Onto Hepatitis E/M Dollars With 4 Tips
Boost your bottom line by freeing up GI's timeMaximizing your evaluation and management se... Read more
Reader Questions:
Medicaid May Still Require 2007 Codes
Question: I've been getting Medicaid denials for 2008 diagnosis codes. Wasn't I supposed t... Read more
Reader Questions:
Pick Apart This Pylorous Stricture Scenario
Question: My gastroenterologist saw a patient who has a non-passable stricture at the pylo... Read more
Reader Questions:
HNPCC Has 1 V Code Option
Question: How should I code hereditary nonpolyposis colorectal cancer (HNPCC) syndrome -- ... Read more
Reader Questions:
Ask What 'CC' Means Before Proceeding
Question: I came across a chart that states, "cc time 45 minutes." What should I code for ... Read more
Reader Questions:
Get Up to Date With Modifier SG
Question: I heard at a Medicare webinar that as of Jan. 1, we would no longer need to use ... Read more
Reader Questions:
1-Duct Visualizations Count as Full ERCPs
Question: Two weeks ago, the gastroenterologist performed an endoscopic retrograde cholang... Read more
Reader Questions:
Pause Before Reporting Botox Injections
Question: My gastroenterologist performed a Botox injection on a patient with achalasia. H... Read more
You Be the Coder:
Ace Your AVM Procedure Code
Question: My physician saw a patient who has blood in stool. He performed a colonoscopy an... Read more
Cure Your Colonoscopy Denials by Following CMS' Advice About Screening vs. Therapeutic
Guidance concerning what diagnosis codes you should report may surprise you If you're con... Read more
Focus on Crohn's Disease:
Plot Your Crohn's Coding Course, From Dx to Treatment
Sorting out these office visits from the rest could be a saving grace You know that a hig... Read more
Physicians and E/M Coding:
6 Tips Will Clean Up Your Doctor's HPI Documentation
Hint: Get others involved to deliver the best possible claim Helping your gastroenterolog... Read more
Reader Questions:
Master Incomplete ERCP Modifier Usage
Question: I'm coding an ERCP, and the doctor made numerous attempts with the catheter tip... Read more
Reader Questions:
Watch Out for Screening Versus Surveillance
Question: A 52-year-old patient came into our practice last year, and the gastroenterolog... Read more
Reader Questions:
Here's What to Charge for Telephone E/Ms
Question: Will Medicare cover the new telephone evaluation services (99441-99443) in 2008... Read more
Reader Questions:
Avoid Paybacks for Cloned Documentation
Question: I often use previous electronic medical record (EMR) charts with the same chief... Read more
You Be the Coder:
Cirrhosis Diagnosis
Question: A patient’s medical record reads, "Cirrhosis likely secondary to al... Read more
CPT 2008 Update:
Bring Your PEG Procedure Claims Up to the Latest Standard
Bonus: Be the first to know how to use the 2 new fecal occult test codes If you've pegged... Read more
CPT 2008 Update:
Get Paid for Telephone, Online E/M Visits -- Here's How
Discover new codes for medical team conferences Great news: For those gastroenterologists... Read more
Effectively Append Modifier 78 for Surgical Complaints
Learn what percentage of reimbursement you can expect When complications from an initial ... Read more
Reader Questions:
Zero In on Your ICD-9 Rejections
Question: Why does 787.2 require a fifth digit? Since Oct. 1, 2007, my payers have reject... Read more
Reader Questions:
Clear Up Established Patient Consults in ED
Question: If another physician calls our gastroenterologist to the emergency department (... Read more
Reader Questions:
Payer, Location Make the Modifier Difference
Question: Is it correct to use modifier 74 to describe a colonoscopy in which the physici... Read more
Reader Questions:
Fixate on This Correct Modifier 59 Placement
Question: When we're following Correct Coding Initiative (CCI) edits, which code should w... Read more
You Be the Coder:
Capture Capsule Endoscopy Reimbursement
Question: If our gastroenterologist administers a capsule endoscopy in the office, does 9... Read more
Coordinate Your Pill Cam Claims to Capture the Right Codes Every Time
Bonus: When the capsule is lodged in the patient's stomach, discover what you should do K... Read more
Take a Practical Approach to 2 Providers Placing a PEG Tube
Surprise: A modifier is a better option than submitting 2 codes When reporting a percutan... Read more
Physicians and E/M Coding:
Get Your Gastros In Line With This E/M History Levels Advice
Securing the correct history level is easy with this element-by-element study Warning: Ga... Read more
Reader Question:
Exhale: ERCP Code Doesn't Mention Approach
Question: My gastroenterologist did an intraoperative sphincterotomy. The surgeon is bill... Read more
Reader Question:
Check Balanced Budget Act for Supervision Rules
Question: If a nurse practitioner (NP) or physician assistant (PA) performs a diagnostic ... Read more
Reader Question:
No Face-to-Face Time? No E/M Service
Question: My gastroenterologist wants to charge for a visit with a patient's son (who is ... Read more
Reader Question:
If Pouchitis Is Infectious, Pick 2 Dx Codes
Question: What diagnosis code should I use for pouchitis? And does the ICD-9 code change ... Read more
Reader Question:
Avoid the Level-3 E/M Rut
Question: I think my gastroenterologists frequently perform established patient office vi... Read more
Reader Question:
Get Your Gastro Paid for H. Pylori Analysis
Question: Our gastroenterologist performs tests for Helicobacter pylori (H. pylori) using... Read more
You Be the Coder:
Dislodging a Bolus May Not Mean FBR
Question: I have a chart to code that has the following findings: "I found a bolus of mea... Read more
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