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Gastroenterology Coding Alert

News You Can Use:
Fee Schedule Cuts Medicare Pay By 21.2%, Scraps Consults
Bonus: CMS increases pay for office visit codes. Get ready for another year of nail-bitin... Read more
3 Tips Help You Make the Most of Your Laparoscopy Pay
Capture diagnostic scope or leave $90 on the table. Billing multiple scopes could bring y... Read more
Polish 3 Documentation Skills for Stellar Claims
Help your gastroenterologist grasp key elements to reduce repayments. Documentation error... Read more
Reader Question:
Geography Affects Your Payments
Question: My physician has asked me to explain how to figure out what our reimbursement w... Read more
Reader Question:
Patients Are Not New to Practice With New Doc
Question: We hired a new physician for our practice after another physician left. The new... Read more
Reader Question:
Open to Lap Conversion Doesn't Equal V64.41
Question: The surgeon is doing an open hernia repair through a small incision. He repairs... Read more
Reader Question, Reserve +49568 for Incisional, Ventral
Question: I am billing 49505 and +49568 together and some payers are paying and othe... Read more
Reader Question:
Critical Care Involving a Resident
Question: One of my surgeons, who is a teaching physician, and a resident treated a patie... Read more
Reader Question:
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with 99024 and charge $0. Sometimes it goes through, but ... Read more
You Be the Coder:
Pneumoperitoneum With Enterolysis
Question: My surgeon's op note says that he used a Veress needle to create a pneumoperito... Read more
3 Mythbusters Clear Up Your Complicated Colonoscopy Claims
When a screening procedure turns diagnostic, beware of V76.51 pitfalls. You know your col... Read more
These Quick Tips Will Help You Differentiate Between Modifiers 58, 78, and 79
Tip: For complication with return to OR, look to modifier 78. Can you easily distinguish ... 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 &quo... Read more
READER QUESTIONS:
Observe Bundles for ERCP Code
Question: The gastroenterologist performs a level-two office visit on a new patient, and ... Read more
READER QUESTIONS:
Watch for 'Add-Ons' During Remicade Sessions
Question: An established patient with a plan of care in place for his Crohn's disease of ... Read more
READER QUESTIONS:
Catch Visit Details When Coding Sedation Services
Question: The gastroenterologist meets an 83-year-old established hospice patient at the ... Read more
READER QUESTIONS:
Could Ending 99241-99255 Pay Help Your Practice?
Question: I'm hearing that consultation codes (99241-99255) will go away in 2010. How wil... Read more
READER QUESTIONS:
Know Base Colonoscopy Components for Best Coding
Question: I have encounter notes that indicate the gastroenterologist performed a "Colono... Read more
READER QUESTIONS:
Be Ready When Screen Turns Diagnostic
Question: A 68-year-old established Medicare patient with a history of colonic polyps rep... Read more
READER QUESTIONS:
Counseling/Coordination Domination? Consider Time-Based Coding
Question: An established pregnant patient with a plan of care in place for her gastroesop... Read more
You Be the Coder:
Get Your Sphincter Tear Dx Right Every Time
Question: A new patient reports to the gastroenterologist complaining of rectal pain. Enc... Read more
CCI 15.3 Update:
: CCI 15.3 Update: Watch for Fluoro, Moderate Sedation Bundles or Face Denials
Tip: Modifier 26 may be your key to separate reimbursement for professional services. ... Read more
Stop Forfeiting up to $779 for Appendectomy Procedures
2 requirements open the door to adding on 44950-44970. Do you assume payers will bundle a... Read more
Clip and Save:
Always Choose the Appropriate Appendectomy Code
This flowchart makes capturing allowed 44960s a snap. To make your appendectomy coding... Read more
News You Can Use:
CMS Proposes Elimination of Consultation Pay on Jan. 1
The goal: Eliminate confusion over transfers of care. If you cringe every time you see th... Read more
Reader Question:
Try Add-On Code for Cholangioscopy
Question: What CPT code should I use to report the new SpyGlass visualization system? New... Read more
Reader Question:
Include Decompression in Colonoscopy
Question: Is there a code for colonoscopy with decompression of the volvulus and tube pla... Read more
Reader Question:
Patient BMI Determines Bariatric Coding
Question: I heard that Medicare made some changes about diabetic patients' eligibility fo... Read more
Reader Question:
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
You Be the Coder:
Placement of J-Tube
Question: My gastroenterologist did a placement of jejunostomy feeding tube (j-tube) thro... Read more
Avoid Medicare Screen Miscodes With This FAQ
Steer clear of G0121 denials by observing 10-year rule. If you slip up on screening colon... Read more
Head to Medicare LCDs for Specific High-Risk List
Your G0105 pay hinges on sticking to your carrier's approved diagnoses. You can get a scr... Read more
Earn Another 15% by Making Incident-To Work for You
Physician NPI means you're paid in full on claim. Coders who are not on the lookout for i... Read more
Bring in $400+ for Breath, FOBT-E/M Alone With CLIA Waiver on File
Lab cert adds several screenings to your possible procedure list. Without Clinical Labora... Read more
READER QUESTIONS:
Sigmoidoscopy Often Bundles Services
Question: Notes indicate that the gastroenterologist performs a rigid sigmoidoscopy; duri... Read more
READER QUESTIONS:
Call on Modifier for Hospital G Tube Fix
Question: The gastroenterologist meets an established patient in the hospital to treat a ... Read more
READER QUESTIONS:
Check for Patient Statements When Seeking CC
Question: An established patient comes into the reports to the gastroenterologist complai... Read more
READER QUESTIONS:
Multiple-Papillae? Choose 1 Hemorrhoidectomy Code
Question: I am a bit confused by this op report: A patient with external hemorrhoids and ... Read more
READER QUESTIONS:
Use Caution When Counting ROS Queries
Question: Encounter notes indicate that during the course of an E/M, a patient complains ... Read more
You Be the Coder:
Coding for Bravo Cap Placements
Question: A new patient reports to the gastroenterologist with complaints of frequent bel... Read more
Celiac Diagnosis E/Ms Have Your Head Spinning?
Keep track of the many factors docs must master to nail down payment. Does your physic... Read more
New Liver Tumor, Pouchitis Codes Should Benefit Gastroenterology Offices
Also: Many ICD-9 additions should bolster neonatal, pediatric Dx coding. A patient has... Read more
Beyond 25:
In Rare Cases, You'll Need Different E/M Modifiers
Know when to go to modifiers 24 and 57 when you report E/M with certain hemorrhoid codes.... Read more
Reader Questions:
Bundling Smarts Aid Critical Care Coding
Question: The gastroenterologist treats a patient suffering from critical gastrointestina... Read more
Reader Questions:
Separate Interp From EGD to Max Out Pay
Question: An established patient reports to the gastroenterologist complaining of a burni... Read more
Reader Questions:
Discover Cause Before Coding Control of Bleeding
Question: Our gastroenterologist spots a pair of benign polyps in a patient's sigmoid col... Read more
YOU BE THE CODER:
How Do I Code Radiological G Tube Services
Question: Our gastroenterologist meets an established Medicare patient with a malfunction... Read more
4 Tips Get Your Gastroenterologist to Write Reimbursable Endo Reports
Help your office get paid when doc makes your job easier. Coders ask questions all the... Read more
Templated EHRs Could Result in Incomplete Endo Notes
Physicians must take care that the record actually matches what they did. If you use a te... Read more
Clip 'n' Save :
Endoscopy-Coding Checklist for Physicians
Here's a handy reference for when your gastroenterologist dictates an endoscopy report. If... Read more
How Do I Know Which Code Gets Modifier 59?
With all the CCI bundling going on,it's time for a refresher on unbundling. Nowadays, whe... Read more
Don't Let CCI 15.1's 300,000 Additions Scare You
Most new bundles won't affect your bottom line. If the news about the huge set of new Cor... Read more
Don't Make These Common Mistakes When You Append Modifier 59
• Never append modifier 59 to any E/M service code. It's for procedures only. • ... Read more
READER QUESTIONS :
Choose E/M Code for Dilation Without Anesthesia
Question: My gastroenterologist performed an anal dilation in the office. The CPT only li... Read more
READER QUESTIONS :
45380 Describes 1 or Several Biopsies
Question: My gastroenterologist performs mapping biopsies on patients who have inflammato... Read more
READER QUESTIONS :
Colostomy, Colotomy Determine Code Choice
Question: What's the difference between 44388 (colonoscopy through stoma) and the code 45... Read more
READER QUESTIONS :
There's No Procedure Code for PEG-Tube Removal
Question: I haven't been able to find a code for gastrostomy tube removal without an endo... Read more
READER QUESTIONS :
Don't Let Brand Name Confuse Your Coding
Question: Our physicians are using a Third Eye retroscope. I am trying to find a CPT code... Read more
You Be the Coder :
Do You Know the ICD-9 Code for This Referral?
Question: What is the diagnosis code for "positive ColoSure." A patient was sent to our p... Read more
Use New Hemorrhoid Destruction Code Correctly or Miss Out on $190
Dont forget the 90-day global period on 46930. If your gastroentero... Read more
News You Can Use:
Medicare Proposes Pulling Payment for Virtual Colonoscopies
The debate over colonography continues. Medicare has proposed not t... Read more
Too Many Diagnoses to Choose From?
CMS, ICD-9 say theres a time to code symptoms, a time to code findings. ... Read more
READER QUESTIONS:
Which Code Is Right for Fissure Cauterization?
Question: Our doctors cauterize fissures to stimulate granulation tissue for better heal... Read more
READER QUESTIONS:
Physicians Often Use Clips to Control Bleeding
Question: Our op note says colonoscopy withapplication of Resolution clip. Fle... Read more
READER QUESTIONS:
Call on G0105 for 'High-Risk' Screenings
Question: A Medicare patient has a family history of colon cancer. Five years ... Read more
READER QUESTIONS:
How Do I Code When 1 Physician Stands In for Another?
Question: One of our physicians is going out of the country on vacation. Were ... Read more
READER QUESTIONS:
Use Modifier When Capsule Endoscopy Goes Awry
Question: Our patient came in for a capsule endoscopy, but the capsule got stu... Read more
READER QUESTIONS:
What's the Correct Dx for Bleeding After Polyp Removal?
Question: What diagnosis should I code for a postpolypectomy bleed? I have bee... Read more
READER QUESTIONS:
What Is NERD?
Question: In the doctors notes, it states the patient has NERD. What does this... Read more
READER QUESTIONS:
Incomplete Screening Colonoscopy? Append Modifier 53
Question: A Medicare patient came in for a screening colonoscopy. My gastroent... Read more
You Be the Coder:
Get Your Modifiers Straight When Physicians Double Up on PEG Tube
Question: We recently hired a practice consultant who advised us that we are c... Read more
Say Goodbye to G0394 and Still Get Your FOBT Test Payment
Don't be fooled: 1 fewer occult blood code actually makes coding clearer. If your gastroe... Read more
Review:
Choose the Correct FOBT Code
Now that you have one less code to worry about, here's how. Here are the coding-decision ... Read more
Master Past, Family, Social Hx to Knock Out E/M, Dx Coding
Good notes point you to codes that support services. When your physician performs an E/M ... Read more
Support Screening Eligibility With PFSH Clues
For Medicare patients, personal and family history can determine how you code a screening... Read more
READER QUESTIONS:
Symptom Code Matches Stomach Description
Question: What is the diagnosis code for antral erythema? Ohio Subscriber Answer: If your... Read more
READER QUESTIONS:
Zero Means Never When It Comes to CCI Bundles
Question: Our colorectal surgeons periodically perform an anoscopy (46600) and a proctosi... Read more
READER QUESTIONS:
What to Do When Doctor Says 1 Thing,Notes Say Another
Question: How would you code this office visit? Another office refers a 49-year-old patie... Read more
READER QUESTIONS:
Endo Loop Suggests Snare Technique for Polyp
Question: What code describes this procedure? A single 20 mm pedunculated polyp with no s... Read more
READER QUESTIONS:
Term Indicates Severity of Patient's Esophagus Problem
Question: How should I code the diagnosis "Barrett's with high-grade dysplasia?" Alaska S... Read more
You Be the Coder:
Compare Your EGD Coding to Our Expert
Question: What procedure codes would you use for this patient encounter? The patient was... Read more
Don't Wait for New CPT Codes;Maximize Virtual Colonoscopy Payment Now
Learn whether to file an ABN with 0066T, 0067T. CMS is set to decide in February whether ... Read more
Develop a System to Deliver the Best Bang for Your PQRI Buck
A coder shares lessons learned from the first two years. If you really want that 2 percen... Read more
READER QUESTIONS:
Call on Injection Code for Pre-Surgical Marking
Question: What procedure code should I use for a flexible sigmoidoscopy to 15 cm and only... Read more
READER QUESTIONS:
Use Benign-Lesion Code for Stoma Repair
Question: Our gastroenterologist treats a patient who has a gastrostomy tube. The op note... Read more
READER QUESTIONS:
2 Codes Needed for Capsule Placement, Reading
Question: What is the code for placing a small bowel capsule by way of an EGD? Louisiana ... Read more
READER QUESTIONS:
What's the Code for Weight Loss After Gastrectomy?
Question: I need a code for a patient with weight loss and history of gastrectomy. Should... Read more
READER QUESTIONS:
Sounds Like 2 Procedures, but Use Just 1 Code
Question: My physician's note says "EGD with removal of a dysfunctional PEG tube and plac... Read more
READER QUESTIONS:
Photography Is Part of the EGD
Question: My provider is billing an EGD, and in his op report he states that he obtained ... Read more
READER QUESTIONS:
Look for More Details on 'Mucosal Resection'
Question: What is the code for endoscopic mucosal resection? Kentucky Subscriber Answer: ... Read more
You Be the Coder:
Can You Remove All Doubt About This Stent Removal?
Question: My physician gave me charges for an EGD with foreign-body removal connected to ... Read more
Should Your Office Jump On the PQRI Bandwagon?
Take a look at the new hepatitis treatment codes before you turn down a 2 percent bonus.Do... Read more
Wanted:
Physicians to Get on Board With E-Prescription Systems
PQRI isn't the only program to offer physicians an enticement.In 2009, your physicians are... Read more
Good ROS Documentation Today Helps Keep the Auditors Away
Learn how to justify those level-4 and -5 E/Ms your physician is performing.You already kn... Read more
Reader Questions :
Learn to Untangle a Common Unbundling Problem
Question: We have physicians that commonly do an EGD with biopsy (43239) and EGD with ball... Read more
Reader Questions :
These 2 Colonoscopy Codes Aren't Bundled
Question: Can I report CPT 45380 and 44388 together?Minnesota SubscriberAnswer: Yes, if ... Read more
Reader Questions :
Where Can I Find a Crosswalk for Add-Ons?
Question: I am getting a denial for an add-on code, saying it was not billed with the corr... Read more
Reader Questions :
New vs. Established Doesn't Depend on Geography
Question: A patient shows up at our office complaining of nausea. A gastroenterologist at ... Read more
Reader Questions :
What's the Right Code for Fluid Collection?
Question: My doctor performed an ERCP with pancreatic duct fluid collection. Her report di... Read more
Reader Questions :
Medicare Won't Pay for E/M Without a Patient
Question: Should we bill an office visit (99211-99215) for a consult with a family member ... Read more
Reader Questions :
NPP in Office + GI in Surgery = No 'Incident-To'
Question: We operate a large facility with several separate entities that include a gastro... Read more
Reader Questions :
Use Modifier 51 to Show Multiple Hemorrhoids Removed
Question: Our doctor removed two hemorrhoids by simple ligature using 46221. Would I list ... Read more
Prepare Now:
CPT 2009 Offers Ammo for New ERCP Procedure
Learn the new infusion and hydration codes or face denials on Jan. 1. Do you ever struggle... Read more
Say Goodbye to Modifier 21;Just Use +99354-+99359 in 2009
Soon, you'll have only the more specific way to report prolonged services.Have you tried a... Read more
News You Can Use:
Coding to 'Get Paid'? Watch Out: You Could Be Liable
You don't have to actually make money to be liable for filing a false claim, according to ... Read more
New Laparoscopy Codes Arrive
If your office has been performing laparoscopies to repair hernias, rejoice. You just got ... Read more
Reader Questions :
Consider 'Unlisted' Code for This Procedure
Question: Our physician has done a dilation of stricture of the sigmoid colon with a Savor... Read more
Reader Questions :
Cryptectomy Has to Bundle With Scoping
Question: My gastroenterologist performed a proctosigmoidoscopy on a patient and removed a... Read more
Reader Questions :
Record Review Isn't a Separate Service
Question: My gastroenterologist wants to bill for the time he spends reviewing medical rec... Read more
Reader Questions :
How Do I Code 2 Polyp Removals?
Question: A patient comes into the ASC for a screening colonoscopy; the physician finds an... Read more
Reader Questions :
Code This Multi-Procedure Endoscopy
Question: What is the appropriate CPT code for an EGD and Keofeed tube insertion into the ... Read more
Reader Questions :
Don't Code Screening as Diagnostic
Question: My gastroenterologist performs a screening colonoscopy on a patient. We do not h... Read more
You Be the Coder:
How Do I Code a Blood Clot Removal?
Question: A patient has a hiatal hernia with a Mallory-Weiss tear and upper gastrointestin... Read more
Here's Your Complete Guide to the Incomplete Colonoscopy
Don't let the discrepancy between CPT and CMS keep you from payment. Your gastroen... Read more
Clip and Save:
Know Your Way Around an 'Incomplete' Colonoscopy
The intent must be to reach the cecum, and scope must pass the splenic flexure to be com... Read more
You Be tthe Coder:
Get Specific on AVM Coagulation
Question: Our doctor performed an EGD using argon plasma coagulation of duodenal angiody... Read more
Medicare:
No OR Means No Separate Coding
Remember that when you're coding complications, modifier 78 isn't the only optio... Read more
OIG Alert:
Feds Will Scrutinize Colonoscopies
The Department of Health and Human Services Office of Inspector General has issued fair ... Read more
Say 'Yes' to 3 Questions Before You Append 78
Hint: The physician must return the patient to the operating room. Need to know when... Read more
Reader Question:
Where Did 'Malignant Variant' Come From?
Question: A referring physician sent us progress notes with this diagnosis: "Crohn's disea... Read more
Reader Question:
Consider 43247 for This EGD
Question: My doctor performed an esophagogastroduodenoscopy on a patient who had a food im... Read more
Reader Question:
Don't Keep Coding Full Hepatitis Panel
Question: Our doctor saw a patient who has a history of hepatitis A. To monitor the patien... Read more
Reader Question:
Dilation Is Separate From Endoscopy
Question: Our gastroenterologist performed an endoscopy to the duodenum. He found a mild S... Read more
Reader Question:
What's All This About NEC and NOS?
Question: What do "NOS" and "NEC" mean in diagnosis coding? How do I tell the difference b... Read more
Reader Question:
Get the Right FOBT Code for Medicare
Question: How do I code a fecal occult blood testQuestion: How do I code a fecal occult bl... Read more
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