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Gastroenterology Coding Alert
Gastroenterology Coding Alert
Gastroenterology Coding Alert - 2010; Volume 12, Number 12
CPT 2011:
Rejoice -- You've Got New Codes for Colon Motility and Manometric Studies
Don't overlook two revised codes for esophageal pH monitoring. If you've been ...
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Clarified:
Modifiers 52, 53 Call It 'Quits' for Incomplete Scope
Suppose your gastroenterologist performs a procedure on a patient who is scheduled and pre...
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Diagnosis Coding:
Dysphagia 101: Synch Your Knowledge with CPT and ICD-9 Guidelines
CPT has a lone code to fit most of dysphagia-related treatment. Find out what.If you're of...
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Documentation:
Hail to the Chief -- Complaint: Here's What You Might Be Missing
Chief complaint need not be the top note, but physicians must state it clearly.Getting din...
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Reader Questions:
Colon Cancer High-Risk Patients Defined
Question: How is a patient considered high risk for developing colorectal cancer?Maine Sub...
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Reader Questions:
578.9, 456.20 Are Cirrhosis Diagnosis Options
Question: My gastroenterologist sees a patient for a "cirrhosis likely secondary to...
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Reader Questions:
When Is A Colonoscopy Complete?
Question: What would be the appropriate modifier to use when the doctor does reaches the c...
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Reader Questions:
Modifier 78 Takes You Back to the OR for a Different Procedure
Question: A Medicare patient returns to the endoscopy lab at 4 p.m. to control a bleeding ...
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You Be the Coder:
43201, 43236 Veer Away from Old School Botox Injection Coding
Question: My gastroenterologist performed a Botox injection on a patient with achalasia, a...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 11
Hemoccult Test:
82270, 82272, G0107: Ease Your Hemoccult Test Coding With This Advice
Why, who, and where work hand-in-hand to point you to the right code.If you want to keep t...
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Endoscopic Retrograde Cholangiopancreatography:
43262-43269 Is Your Guide to Profitable ERCP Coding
Get paid twice the $440 rate for 43268. Find out how.If you think coding for endoscopic re...
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Bleed Control:
43255 Leaves No Stones Unturned for Control-of-Bleeding Situations
Forget about modifier 22 or you'll be stuck in old school.Modifier 22 may not be the ally ...
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Reader Questions:
45335 Gets the Distinctive Modifier
Question: If billing the codes 45334 and 45335 together, which one would get the modifier ...
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Reader Questions:
43248 and 43239: Don't Overlook Your Upper GI Encoscopy Codes
Question: How should I report an endoscopic procedure based on the following op note? "The...
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Reader Questions:
G0105 Screens Your Colorectal Cancer Coding Options
Question: The surgeon prepares a Medicare patient meeting high-risk criteria for a screeni...
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Reader Questions:
153.0-153.9 and 154.0-154.8 Are Go-To ICD-9 Codes for Colorectal Cancer
Question: When should I use a diagnosis of colorectal cancer versus a diagnosis of history...
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Reader Questions:
Symptoms Apply as Primary Diagnosis for "Bacterial
Question: A patient presents with "bacterial overgrowth -- small intestine.&qu...
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Reader Questions:
49659 Best Describes Lap Repair of Hernia in the Intestine
Question: My gastroenterologist performed laparoscopic release and repair of an incarcerat...
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You Be the Coder:
ICD-9 154.1 Is Your Rectal Cancer Bet
Question: A non-Medicare patient who was recently diagnosed with rectal cancer underwent a...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 10
Colon Cancer Screening:
G0121 Offers the Best Choice for Coding Colon Cancer Study
Frequency rules vary for average, high risk patients. If you're coding for colorec...
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Small Intestine Probe:
91110 and 91111: Partners in Small Intestine Study
Repeat studies demand this modifier.When your gastroenterologist uses capsule study to obt...
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Surgical Coding:
46250-46262: Bypass 3 Myths When Coding Int/Ext Hemorrhoidectomy
Unlisted procedure for anus has got more company than what you thinkYou're facing a blank ...
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Reader Questions:
+96375 Resolves Benadryl Infusion Dilemma
Question: How should I code this encounter: An established patient with a plan of care in ...
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Reader Questions:
43235 and 91035 Work Hand-in-Hand
Question: A gastroenterologist sees a new patient complaining of frequent belching and hea...
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Reader Questions:
Here Come the Latest CCI Edits
Question: A coder in my practice is asking me a lot of questions about CCI Edits 16.3. Wha...
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Reader Questions:
45305 Bundles Anoscopy and Mucous Membrane Biopsy
Question: My gastroenterologist performed a rigid sigmoidoscopy, along with anoscopy witho...
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Reader Questions:
43235- 43259: Location and Treatment Method on Documentation Matters
Question: I'm preparing a documentation checklist for endoscopy. What information should I...
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Reader Questions:
Co-existing Med Condition Is a Requirement for Anesthesia Service
Question: When I coded 00810 for anesthesia service during an esophagogastroduodenoscopy (...
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Reader Questions:
G0121 Accepts No Other ICD-9 But V76.51
Question: A 73-year-old established Medicare patient with average risk for colorectal...
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You Be the Coder:
45378 In Place of an E/M Code
Question: A patient, referred by his physician, presents to our office for a diagnostic co...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 9
Mythbuster:
Bust 3 Myths for Simplified GERD Dx Test Coding
Find out why modifiers are out of the question for 91034.Whether your gastroenterologist r...
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Surgical Coding Quiz:
Optimize Your Code Selection for Enterostomy Closure
Ask the right questions, and you shall have the answers.Do you want a headache-free search...
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News Update:
Dodge Claims Rejection by Becoming PECOS-Certified
Medicare postpones July 6 implementation and works to streamline enrollment process.You do...
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Enterestomy Closure Solutions:
Count Location and Time as Closure Coding Prerequisites
Your surgeon's op report plays crucial role.When a physician closes a colostomy, resection...
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Reader Questions:
Stick with Modifier 59 for Colonoscopy + Polypectomy
Question: What modifier should I use when a gastroenterologist performs colonoscopy, and d...
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Reader Questions:
Dysphagia Coding Woes? We've Got the Answer
Question: How should I code the treatment procedure for difficulty in swallowing (dyspha...
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Reader Questions:
Report 99080 at Your Own Risk
Question: I did some paperwork for a patient in my practice. Can I bill for it?Tennessee S...
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Reader Questions:
Deal with Foreign Body Removal Based on Documentation
Question: A surgeon worked on a patient to repair a reducible umbilical hernia. During the...
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You Be the Coder:
Reserve Stage-IV Ulcer Codes for Worst Cases
Question: I'm looking for the right ICD-9 code that specifically describes pressure ulcer....
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Gastroenterology Coding Alert - 2010; Volume 12, Number 8
Tube Placement:
Get on the Fast Track to Tube Changes Claim Success by Zeroing in These Key Terms
Find out what codes include fluoroscopic guidance.When your gastroenterologist deals with ...
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Colonoscopy:
Fit Your Colonoscopy Exam Coding According to Diagnosis
G-codes are handy if the screening doesn't turn diagnostic. You know the deal: If ...
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Modifiers:
Examine the Circumstance Before Using Modifier 52, 53
Anesthesia plays a role, too!When your gastroenterologist ends a procedure early, it autom...
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Reader Questions:
Put Colonoscopy Dx in the Right Order
Question:A patient comes in for screening colonoscopy that turns therapeutic. Could you cl...
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Reader Questions:
Mark Off Similar Proctosigmoidoscopy Codes
Question:A patient underwent formalin chemical fulguration of rectal mucosa with rigid sig...
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Reader Questions:
Exchange Feeding Tubes, and Get Paid with 44372
Question:I need help with the CPT for the removal and replacement of a clogged transgastri...
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Reader Questions:
Billing Photo Documentation? Not So Fast
Question:My provider is billing an EGD. He states in his op report he states that he obtai...
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Reader Questions:
Screening of Diagnostic? Choose the Appropriate FOBT
Question:The gastroenterologist in my practice orders fecal occult blood test (FOBT) for a...
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You Be the Coder:
Prepare To Report 43247 When Peeking Into Upper GI Tract
Question:I'm not sure if the physician did an esophagogastroduodenoscopy (EGD) by removing...
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Gastroenterology Coding Alert - 2010, Volume 12, Number 7
Lower Endoscopy Coding:
Reporting Lower GI Scope? Wait Till You Get the Big Picture
Highlighting how far the scope goes could be your clue.Colonoscopy is not the only lower e...
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Diagnosis Coding:
3 Tips Clear Up Your Dysphagia Coding Woes
Make sure you specify type. Diagnosing dysphagia is often not cause for alarm among ga...
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Modifiers:
Follow 5 Steps for Modifier 22 Claim Success
Your documentation determines the 'unusuality' of the situation.Payoff: The Medicare rate ...
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Reader Questions:
Look To 99211 for New-Med Regimen Encounters
Question: The gastroenterologist sees an established patient with a plan of care in place ...
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Reader Questions:
Give pH Monitoring a New Treatment
Question: I can't find a CPT that takes into account the prolonged nature of a seven-hour ...
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Reader Questions:
Report External Hemorrhoid Removal with 3 Options
Question: I heard gastroenterologists sometimes treat external hemorrhoids, aside from tre...
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Reader Questions:
Make Sure 3 Conditions Fit For 91065
Question: My gastroenterologist performs a hydrogen breath test for fructose intolerance. ...
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You Be the Coder:
Get Your Tube Fix Claim Right Using Descriptor as Key
Question: Our gastroenterologist treats a patient whose gastrojejunostomy tube has migrate...
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Gastroenterology Coding Alert - 2010, Volume 12, Number 6
ICD- 9 2011 UPDATE:
Prepare to Get Specific With New Fecal Incontinence Codes for 2011
Personal history, fecal impaction codes round out list of gastroenterology diagnosis chang...
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Foreign Body Removal:
Don't Get Stuck With Denials When Coding For Foreign Body Removals
Removing or moving foreign body -- the answer will lead you to two different codes.De...
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E/M Primer:
Scope Out Potential Level 4 and 5 E/Ms By Knowing Crucial HPI Facts
Watch out for CPT/Medicare differences when counting HPI elements.If you're not accurately...
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Clip and Save:
Capture HPI Elements Using These Questions
Get your gastroenterologist to capture the information you need with this handy list.When ...
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Reader Questions:
Follow the 3-Year Rule
Question: My gastroenterologist met with a patient in the office at the patient's request ...
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Reader Questions:
Bill All Scopes if No Parent
Question: The gastroenterologist performs a biopsy with sigmoidoscopy followed by an endos...
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Reader Questions:
ED Visit + Critical Care? Report Only 99291
Question: A patient with abdominal pain presents to the ED, where the on-call gastroentero...
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Reader Questions:
Skip Code for Biopsy-Caused Bleeding
Question: The gastroenterologist injected epinephrine into a duodenal ulcer to control act...
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Reader Questions:
Achalasia Requires Unique Code
Question: My gastroenterologist used an esophageal dilation to treat achalasia (530.0) by ...
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Reader Questions:
Get to the Bottom of Ascites Codes
Question: A 52-year-old female presented with worsening abdominal distension and a 15-poun...
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Reader Questions:
Review G-Tube Replacement Procedure Before Choosing 43760
Question: The gastroenterologist treated a nursing home patient in the emergency departm...
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You Be the Coder:
Get To Know Most Frequent Multiscope Code
Question: The gastroenterologist treats a patient for bleeding gastric ulcers and also tak...
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Gastroenterology Coding Alert - 2010, Volume 12, Number 5
Pill Cam Procedure Coding:
Visualize Easy PillCam Coding with 3 Expert Tips
Choose 91110 vs. 91111 based on the view.If your gastroenterologist uses a capsule study t...
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Quick Quiz:
How Much Do You Know About Consultation Codes?
Be aware of cms /cpt guideline differences to avoid denials.When your gastroenterologist p...
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Answer 1:
Check With Your MAC for Guidance
When your gastroenterologist sees a Medicare inpatient and would have used an inpatient co...
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Reader Questions:
For Complete ROS, Check at Least 10 Systems
Question: A new patient reports to the gastroenterologist with heartburn, stomach ache, an...
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Reader Questions:
Use Modifier 78 for Return to OR
Question: The gastroenterologist cauterizes three internal hemorrhoids with a heater probe...
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Reader Questions:
Tackle ERCP + Spincterotomy With Codes
Question: My gastroenterologist performed a pancreatic stent placement during an ERCP with...
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Reader Questions:
Be Confident in Coding for Teaching Physicians
Question: A resident in our office sees a new patient complaining of heartburn. The reside...
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Reader Questions:
Avoid Confusion when Coding EGDs with EUS
Question: A patient with a gastric ulcerating mass came in for an esophagogastroduodenosco...
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You Be the Coder:
Hydration Codes Bundled with Remicade Infusion
Question: A patient came in to our office for a Remicade infusion to treat her Crohn's dis...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 4
CCI 16.1 Update:
Watch Out for New Hemorrhoidectomy, Fluoroscopy Coding Hurdles
The upside is that you'll be able to break some bundles with modifier 59. Just as you're ...
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Check the Modifier Indicator Before Overriding CCI Edits
Key: Make sure your documentation will stand up to scrutiny before appending 59. In certa...
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Case Study:
Tackle PEG Tube Co-Surgeon Challenges Using Modifier 62
Don't fall into the trap of always using modifier 80. When your gastroenterologist works ...
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62 vs. 80
Modifier 62 (Two surgeons): You should look to modifier 62 when your gastroenterologist ...
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Don't Become Ensnared in Polyp-Removal Codes
Choose the right code by pinning down the removal method. If you don't correctly code you...
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Reader Questions:
Consider Base Code Included in 45334
Question: My gastroenterologist performed a diagnostic sigmoidoscopy (45330), followed by...
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Reader Questions:
Use 53 for Procedure Halted for Health Reasons
Question: The gastroenterologist performed a diagnostic upper gastrointestinal endoscopy ...
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Reader Questions:
Use ED Codes With Confidence
Question: A patient with acute gastroenteritis comes to the emergency department (ED). Th...
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Reader Questions:
Append Modifier 25 to Differentiate E/M Services
Question: The gastroenterologist saw a new patient with rectal bleeding. She provided an ...
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Reader Questions:
Link Initial, Subsequent Procedures with Modifier 78
Question: A patient has hemorrhoids and my gastroenterologist cauterizes three internal h...
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Reader Questions:
Face Time Is Essential to Established Patient
Question: Our practice performed a test on a patient who was referred to us by another do...
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You Be the Coder:
Sometimes You May Need a Separate E/M Code
Question: My gastroenterologist treated a nursing home patient in the emergency departmen...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 3
Medicare Knowledge Can Help You Reap Full NPP Benefits
Plan of care is a must for incident-to- billing. Gastroenterology practices that don't ta...
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Safely Pick Between EGD and Enterosocpy Codes Using Key Documentation
Medical necessity should be the governing factor -- not depth or scope type If yo...
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Key Guideline Ensures Accurate GI Scope Every Time
Find out CPT, Medicare, private payers' take on 43239 and 43248 claims.If you confuse comp...
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Be Aware of Medicare Screening Requirements Or Rick Payment Denial
Following 10-year-rule eliminates G0121 rejection.If you slip up on screening colonoscopy ...
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Reader Question:
Append Modifier 78 for Unplanned Return to OR
Question: My gastroenterologist placed a gastrostomy tube. Then, the tube leaked eight day...
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Reader Question:
Designate Separate E/M with 25
Question: During a meeting with a patient complaining of heartburn, my gastroenterologist ...
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Reader Question:
Support In-Office FOBT Services With Dx
Question: A 68-year-old established patient reports to the gastroenterologist complaining ...
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Reader Question:
List Definitive Reflux Dx When Doc Gives Details
Question: An established patient presented with difficulty swallowing. My gastroenterologi...
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Reader Question:
Employ 59 for Stents Placed in Multiple Ducts
Question: If my physician places stents in both the pancreatic and bile ducts, do I only b...
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Reader Question:
Maximize E/M Service Payments for Hepatitis Patients
Question: My gastroenterologist recently saw a patient at the request of the primary-care ...
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You Be The Coder:
Reason for Admission Determines Code
Question: A patient with Crohn's disease was admitted to the hospital for a gastrointestin...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 2
Follow This Lower GI Guide for Help Navigating Endoscopies
A single centimeter can change code choice for these procedures. Confused about those ope...
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Use This FAQ to Get on the Level With Your ROS Coding
Remember, ROS errors can ruin E/M level assignment. A lack of E/M coding smarts can cost ...
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Use This List for ROS Success
Also, check if your payer uses Medicare ROS rules. Coders have to count systems constantl...
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READER QUESTIONS:
Check LCD When Considering High-Risk Dx
Question: A 65-year-old established Medicare patient with regional enteritis and a family...
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READER QUESTIONS:
Combine G Code With Dx for Requested DRE
Question: I had a Medicare beneficiary ask for a prostate exam. Our doctor dictated the e...
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READER QUESTIONS:
Ensure Counseling Claims With Pointed Questions
Question: Can I report alcohol cessation counseling codes along with E/M codes, or do I h...
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READER QUESTIONS:
Go Straight to Source for CC Info
Question: A patient comes into the gastroenterologist with complaints of upper GI pain, u...
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READER QUESTIONS:
Remember These Rules for Patient-Supplied Injections
Question: A patient receives office injections for vitamin B12. She supplies the medicine...
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You Be the Coder :
Visibility Matters On Hematuria ICD-9
Question: Encounter notes state that a new patient reported to the gastroenterologist com...
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Gastroenterology Coding Alert - 2010; Volume 12, Number 1
Here's How to Code Fearlessly for FOBT Servicess
Proper patient participation a must for 82270. Coding for your gastroenterologist's fecal...
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Dig Into This Critical Care FAQ to Avoid Leaving $45 on the Table
Do your physicians know what's bundled into 99291? Your gastroenterologist reports to a l...
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Steer Clear of This Continuous Time Trap
Check out this advice on 'split' CC visits. When a gastroenterologist leaves a critically...
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News You Can Use:
Coming Your Way Soon: Pre-Pay Edits for Nursing Facility E/Ms?
Check out this advice on 'split' CC visits. If you think CMS is only watching your E/M co...
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Clarification:
Clarification:
The Reader Question "Observe Bundles for ERCP Code," in Vol. 11, No. 11 of Gastroenterolo...
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READER QUESTIONS:
Select 99211 for Most Med Checks
Question: An established patient with a plan of care in place for her gastroesophageal re...
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READER QUESTIONS:
Scheduling Sessions Squelches Most E/Ms
Question: Our gastroenterology practice recently opened an infusion suite on site --...
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READER QUESTIONS:
Counseling Must Dominate Exception Claims
Question: A new patient with a chronic gastric ulcer meets the gastroenterologist for man...
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READER QUESTIONS:
Use Physician Notes to Narrow Crohn's Choice
Question: A new Medicare patient reports to the gastroenterologist with complaints of dia...
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You Be the Coder:
Bundles Abound for 45331 Code
Question: The gastroenterologist performs expanded problem focused interval history and e...
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