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Gastroenterology Coding Alert

CPT 2012:
Take An Advanced Peek At Two New Paracentesis Codes For 2012
CPT deletes intraperitoneal catheter insertion code. Do you know what CPT changes will... Read more
Gastroesophageal Reflux Monitoring:
pH + Impedance Testing: CCI Edits Can Get You Out Of A Tight Spot
Time is a factor when choosing between 91037 and 91038. When your physician's note... Read more
ICD-10:
Heartburn Takes On R Code For ICD-10
Tip: Separate codes apply to dyspepsia symptoms. Heartburn, also known as pyrosis or water... Read more
ICD-10 Prep:
2 Tips To Get You Ready For Your ICD-10 Big Leap
Warning: It will be futile to memorize every code set. If you're educating yoursel... Read more
Reader Question:
Get Specific On Ultrasound Abnormal Findings With 793.6
Question: What ICD-9 code should I bill when physician orders a patient for an ultrasound ... Read more
Reader Question:
Mark Colonoscopy Through Stoma Procedures Using 44388-44389
Question: I heard CPT has a different code for colonoscopies performed thru a colostomy ba... Read more
Reader Question:
Reflect Personal History When Coding Surveillance Colonoscopy
Question: If the physician does not state the type of polyp as adenomatous for a "s... Read more
Reader Question:
Support Your Unplanned Return to OR Claim With Modifier 78
Question: My gastroenterologist performed 45385, and discharged the patient. Later on the ... Read more
Reader Question:
Attempted EGD Means Attaching Modifier 53
Question: The GI attempted an EGD on a patient with primary tongue carcinoma who had multi... Read more
Reader Question:
Assisting Physician May Not Deserve 99360 After All
Question: Our surgeons sometimes "standby" for other surgeons in some high-risk procedures... Read more
You Be the Coder:
Skip Modifiers On Subsequent-Day EGDs
Question: My physician plans to perform a repeat EGD on a patient with significant amount ... Read more
Enema Administration:
Case Analysis: Skip Radiology Codes For Rectal Drug Supervision
ICD-9 564.0x should describe constipation, but don't forget to report comorbid conditions,... Read more
Esophagogastroduodenoscopy:
Hold Off Reporting 43255 Unless For Hemostasis
A potential $280 reimbursement could slip through your fingers if you fail to report con... Read more
ICD-10:
Same-Function Codes For Constipation Extend To ICD-10
New code K59.0 will feature four more subclassifications. Constipation (564.0) refers ... Read more
Evaluation and Management:
Adhere To Specific Rules Before Reporting Telephone Care
Phone consults could earn you as much as $25.48 from payers, except Medicare.Physicians an... Read more
Reader Question:
Let 45330 Prove Its Worth By Itself
Question: My gastroenterologist performed a flexible sigmoidoscopy in a facility setting a... Read more
Reader Question:
CPT 17110 Definition Contains Plasma Ablation, Too
Question: Our gastroenterologist treats a patient who has a gastrostomy tube. The op note ... Read more
Reader Question:
Don't Overlook 3-Card Rule for 82270
Question: How should I know when to code for a screening fecal occult blood test (FOBT)?Ca... Read more
Reader Question:
Antral Erythema Translates To 535.4 In ICD-9
Question: What is the diagnosis code for antral erythema?Washington, D.C. SubscriberAnswer... Read more
Reader Question:
Non-Bleeding Varices Treatment: Reserve 43244 For Band Ligation Method
Question: How do you bill for the gastro banding procedure code 43244? Illinois Subscriber... Read more
Reader Question:
Bill A Non Completed Exchange Based On Time Spent
Question: We scheduled a patient for a PEG exchange in the office. His tube had come out a... Read more
Reader Question:
Assert Provider's Entitlement For 43235, 91110 Reimbursement
Question: Our physician places a capsule that we bought through our private practice and h... Read more
You Be the Coder:
Watch Out For External , Endoscopic PDT Disparity
Question: My colleague thinks we should report 96567 for an hour's photodynamic therapy (P... Read more
Diagnosis Coding:
Coding Nondefinitive Diagnoses Remain Your Biggest Challenge
All you need to report are signs and symptoms when diagnostics come back normal.You think ... Read more
ICD-10:
Get Ready To Use K Code For Intra-abdominal Abscess In 2013
Get Ready To Use K Code For Intra-abdominal Abscess In 2013Intra-abdominal abscess refers ... Read more
Esophagogastroduodenoscopy:
Details In The Op Note And Documentation Will Spell The Difference When Coding EGD.
Describe a different site biopsy by attaching modifier 59.If you think you know your way a... Read more
Modifiers:
Spot The Difference Between Modifiers 51, 59
Medicare prefers you don't use one of these modifiers at all. Find out which one.Many code... Read more
Erratum in:
GAC Volume 13 No. 9 August 2011; Error in article text
The article 45380-45385: 3 Tips Put You In Touch With Proper Polypectomy Coding incorrec... Read more
Reader Question:
Fill In Two Of Three E/M Components For Follow-Up Visits
Question: I am auditing some of my gastroenterologist's E/M visits, and discovered that he... Read more
Reader Question:
Reserve A V Code For Stent Removal
Question: The physician's notes simply indicate "foreign body removal of pancreatic stent.... Read more
Reader Question:
'Reason For Visit' Ranks As Top Diagnosis Coding Factor
Question: We generally perform open access endoscopy (no visit is required if the patient ... Read more
Reader Question:
What Code Describes Muir-Torre Syndrome?
Question:  A chart states that the patient is having an EGD due to high risk of cance... Read more
Reader Question:
Get Around Coding For Chromoendoscopy
Question: Can you give some insight into coding for chromoendoscopy? Dye is not injected... Read more
You Be the Coder:
Hot Biopsy Technique Leads You To 45384
Question: Our GI saw a patient for endoscopic biopsy. The patient's mucosa was norma... Read more
CCI Edits:
CCI Edits 17.2: New Edits Ban Use of 45300 With Codes For Therapeutic Anoscopy, Manipulation
Find out what bundles you can bill together using modifier 59.Key changes to the gastroent... Read more
ICD-10:
Hemorrhoid Code Spreads Out in 2013
Beef up your documentation with details such as depth and type.Anoscopy (46600) is a metho... Read more
Polypectomy:
45380-45385: 3 Tips Put You In Touch With Proper Polypectomy Coding
If the surgeon spends double time on 45385, bill with modifier 22.If you know how to work ... Read more
Modifier:
Get The Approval Your Deserve -- If You Know The Ins And Outs To Coding Modifier 58
Clue: Complication procedures go with a different modifier.When a patient takes another tr... Read more
Reader Question:
Documentation Dictates Success of Billing 99212-25 and 43202 Together
Question: A patient presented to the office for his scheduled esophagoscopy with biopsy. B... Read more
Reader Question:
Draw The Line Between Surgical and Diagnostic Laparoscopy
Question: My physician performed an open inguinal hernia repair on an  infant (49491)... Read more
Reader Question:
998.11: Lean On Accuracy For Postoperative Complications
Question: What diagnosis code would you use for post polypectomy bleeding of the colon?Was... Read more
Reader Question:
Don't Expect Payment For 'Healthy' Appendectomy
Question: I heard Medicare and most other payers will not pay separately for the removal... Read more
You Be the Coder:
Watch Out For 49440's Components
Question: The physician's chart says, "The stomach was inflated with air via the nasogastr... Read more
Colonoscopy Exam:
3 Tips Guard Your Colonoscopy Screening Claims Against Costly Denials
V codes fit primary diagnosis, but only for screening high risk patients. Confused abo... Read more
ICD-10:
Use K51.80 With Noncomplicated Ulcerative Colitis
Hint: Identify who is high risk.When a patient presents for a screening colonoscopy (G0105... Read more
Evaluation and Management:
2 Guidelines Keep You From Enigmatic Presentations of Celiac Disease
Be able to tell when to label an E/M service as extended ROS.If you think celiac disease r... Read more
Documentation:
Open Physician-Coder Communication Does The Trick
Be aggressive with your procedure/diagnosis queries for the sake of clarity.In diagnostic ... Read more
Reader Question:
Mark Shaving, Photo Documentation Integral Parts of EGD
Question: My gastroenterologist wants me to bill photo documentation along with an EGD. Ca... Read more
Reader Question:
82270 Entails Three Consecutive Specimen Samples
Question: I'm billing 82270 to report peroxidase-activity fecal occult blood test. Is this... Read more
Reader Question:
Refresh Your ICD-9 Skills With These 3 Signs and Symptoms Code
Question: What code should I report when a patient presents with an upset stomach due to n... Read more
Reader Question:
49442 Secures Your C Tube Insertion Coding
Question: The gastroenterologist advanced an 18-guage needle into the patient's cecum unde... Read more
You Be the Coder:
Save 43247 For EGD With FB Removal
Question: My physician has given me charges for a patient whom he saw in the ER for foreig... Read more
Photodynamic Therapy:
Tips Make Your PDT Coding Hassle-Free
Bill all three or get a denial: supply, injection, and illumination.Coding for photodynami... Read more
ICD-10:
Map Esophageal Carcinoma In Situ Code As Easily As 1-2-3
Must: Prove D00.1's medical necessity when coding for PDT.When a patient receives an injec... Read more
Esophagogastroduodenoscopy:
EGD: Case Studies Enhance Your ICD-9 And Supplementary CPT® Coding Accuracy
Collect a $800+ profit for joint 43235, 91035, and E/M. When evaluating a patient for ... Read more
Documentation:
Move Provider Signature To The Top Of Your Documentation Checklist
Extra: The physician's credentials have a role to play, too.Your CPT® coding may be ... Read more
Reader Question:
565.1 Covers Anal Fistula Diagnosis
Question: What is an anal fistula and what code should I use todescribe it?Washington, D.C... Read more
Reader Question:
No To Colonoscopy for Hemorrhoids and Acute Diarrhea
Question: What are the limitations of colonoscopy (44388-44397; 45355- 45392)? Delawar... Read more
Reader Question:
Is There Such A Condition As NERD?
Question: My physician's notes indicated the patient, who was in for an EGD, has NERD. I'm... Read more
Reader Question:
No Need For 46600 When Reporting 45305
Question: My gastroenterologist performs a rigid sigmoidoscopy. His notes indicate that du... Read more
Reader Question:
Infectious Pouchitis? Report 569.71 Plus Complication Code
Question: Notes indicate pouchitis. How should I report this? Should I consider another ... Read more
Reader Question:
Beware: Hiding Medical Information For Higher Reimbursement Is Fraud
Question: We have a patient that came in 2002 for a screening (referred by his primary car... Read more
You Be the Coder:
Depth and Method Matters For Anorectal Biopsy
Question: How should I report an anorectal biopsy? Louisiana Subscriber Answer: Firs... Read more
PEG Tube Coding:
PEG Tube Removal: Dodge Common Bloopers By Sticking To E/M
Find out why 43247 just won't do you any good. If you've asked yourself freque... Read more
Diagnosis Coding:
Scrutinize Symptoms When Coding C. difficile-Associated Diseases
Loose bowel movement might tell you more than meets the eye.If a patient comes to your off... Read more
Electronic Prescribing:
Lay Your ePrescribing Skills To Good Use
You could be penalized if you don't get your system up before June 30th. If you do... Read more
ICD-10:
Z43.1 Replaces V Code for Gastrostomy Encounter
You won't be in trouble reporting V codes as primary diagnosis.When your office evaluates ... Read more
Reader Questions:
91110: What Date of Service Should You Regard?
Question: When coding for a video capsule endoscopy (91110 or 91111), would you bill for t... Read more
Reader Questions:
Watch Out: CCI Modifier Is Distinct From Payment Modifier
Question: Sometimes I cannot find my two-code pair in the CCI edits. In the CCI edits, how... Read more
Reader Questions:
43273 Gets Handy with ERCP Codes
Question: Should we automatically use the add-on code 43273 with 43260, 43261, 43263-43265... Read more
Reader Questions:
Give Light To Secca Procedure
Question: I've heard about the Secca procedure being utilized as a treatment for fecal inc... Read more
Reader Questions:
Mark NERD And Carditis With 530.81
Question: Has anyone come across chronic carditis on a biopsy taken from the gastroesophag... Read more
Reader Questions:
Describe Bolster Placement With A Reduced Claim
Question: I've heard about PEG tube bolster replacement, and curious about how I should re... Read more
Reader Questions:
What Do You Do With Self-Ingested Overdose?
Question: A patient comes to the office after taking 15 Paxil, nine Ativan, and ingesting ... Read more
Reader Questions:
Is Follow-Up Colonoscopy A Diagnostic Encounter?
Question: A patient comes in for a follow up colonoscopy. The indication is chronic coli... Read more
Reader Questions:
Resolve Your ICD-9 Coding For Liver Metastasis
Question: A patient presents for chemotherapy to treat a secondary liver neoplasm that met... Read more
You Be the Coder:
Can You Combine 43235 and 43220 In A Claim?
Question: The patient is admitted for diagnostic EGD (43235).Preoperative diagnosis indica... Read more
Diagnosis Coding:
2 Tips To Hone Your Colonic Polyp Vocabulary
Uncover how a pathology report can save your claim.Not all patients who present to the off... Read more
Upper Endoscopy:
3 Factors Make Up The Core of EGD Coding
Differentiate "sample collection" from actual biopsy. When your gastroentero... Read more
ICD-10:
Switch to C18.8 When Coding Overlapping Colon Cancer in 2013
New code for ICD-10 will specify contiguous or overlapping sites. When using the ICD-9... Read more
Evaluation and Management Coding:
Observation Services: Learn The Importance of The 8-Hour Rule
Hint: Do not use discharge code 99217 in all observation situations.Sometimes deciding on ... Read more
Reader Question:
Consider Date of Service When Billing 43235 With 91035
Question: In volume 12, number 10 of the Gastroenterology Coding Alert, a reader asked abo... Read more
Reader Question:
Pull Together $473 With Correct 45380 Use
Question: How should I bill a claim based on this medical report? PREOPERATIVE DIAGNOSIS: ... Read more
Reader Question:
74270 Is For Barium Enema… And Water-Soluble Contrast, Too
Question: My gastroenterologist ordered barium enema for a 4-year-old male patient with a ... Read more
You Be the Coder:
Go With 43268 For ERCP Without Sphincterotomy
Question: am new to ERCP coding and trying to figure out how to code this scenario: ERCP w... Read more
Diagnosis Coding:
Rely On G Codes When Coding High Risk Colonoscopy
A hemorrhoid's location should lead you to the appropriate ICD-9. Want to get your... Read more
ICD-10:
Keep It Simple When Reporting Internal Hemorrhoids
Be ready to use an I code to replace 455.0 in 2013.You would typically report internal hem... Read more
Denial Management:
A 3-Step Strategy Could Get You Through Irrational Denials
The contract a patient signs with the insurance company holds true no matter what.Have you... Read more
Audits:
Wonder No More: Successful Internal Audits Are Doable
What does proper scheduling and scrutinizing documentation have to do with your success?Se... Read more
Reader Questions:
V72.83 Is the ICD-9 Code of Choice for Pre-Colonoscopy Visit
Question: We get denials when we bill 99203 or 99204 with diagnosis code V76.51. The insur... Read more
Reader Questions:
45383, 45380: Resolve Your Colonic Hemorrhage Doubts
Question: Our gastroenterologist diagnosed a patient with significiant lower gastrointesti... Read more
Reader Questions:
Don't Be Too Hard On Your Modifier 25 Use
Question: A physician in our clinic said you do not need different diagnosis codes to use ... Read more
Reader Questions:
579.0 Describes Celiac Disease Diagnosis
Question: A patient presents to the office for help, complaining of disturbing gastrointes... Read more
Reader Questions:
45385, 45380: Resolve Colon Polyps With 2 Colonoscopy Methods
Question: How should I report the procedure based on this physician's notes:"Patient with ... Read more
Reader Questions:
Describe Abnormal Feces Fluidity With 787.91
Question: A patient says she has had chronic bowel problems for the last 10 years, with di... Read more
You Be the Coder:
45383, 45381 Take Care of Same-Polyp Intervention
Question: What codes should I use to report this procedure? The olympus scope was passed i... Read more
GI Tract Imaging:
91110, 91111: Get the Answers to Your Toughest Dilemmas
Discover what 3 modifiers you'll use coding capsule studies.When a patient presents to you... Read more
ICD-10:
456.1: Mark Bleeding Varix With An "I" Code
Prepare for a one-to-one shift on the descriptor in 2013.For 91110 and 91111, the patient ... Read more
Coding Quiz:
Coding Quiz: Don't Overlook Flex/Rigid Sigmoidoscopy Disparity
Get fresh know-how from these real life situations.Your gastroenterologist might use sigmo... Read more
Modifier:
Modifiers 52, 53: Avoid Costly Mistakes By Making Appropriate Choices
When a GI decides to discontinue a procedure, do you know what to include in your claim?Wh... Read more
Coding Solutions:
Sigmoidoscopy: Rally Behind Successful Coding Combos
Scoop Up Over $200 by Reporting 44388, 45330 Hassle-Free In all the excitement of addi... Read more
Reader Questions:
EGD-EUS Without Biopsy? Go For 43237
Question: Let's say the gastroenterologist performs an EGD with an endoscopic ultras... Read more
Reader Questions:
574.50 Points to Retained Bile Duct Stones
Question: What CPT and ICD-9 codes should I use for the following Ttube cholangiogram repo... Read more
Reader Questions:
Rectal Exam With Anesthesia? Code 45990
Question: I can't seem to find a proper CPT code for this: The surgeon used a bivalv... Read more
Reader Questions:
43255, Your Go-To Code for EGD With Bleed Control
Question: How should I report an EGD with Argon plasma coagulation performed by our gastro... Read more
Reader Questions:
Consider Important Modifiers When Coding 45382
Question: A patient who initially had a colonoscopy with snare technique (45385) may have ... Read more
You Be the Coder:
569.3, 578.1 Don't Function the Same Way
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an... Read more
CCI Edits:
CCI Edits 17.0: 91117, 91013 Get Their Own Share of Fresh Edits
Mind your gastric intubation coding, too, for conditional pairings. Watch out when coding... Read more
ICD-10:
ICD-10: Be Ready With K Codes for GERD in 2013
Your physician should document if patient has esophagitis.When coding for a motility manom... Read more
Mythbuster:
Appendectomy Coding: Don't Let $84-$860 Pay Disappear Into Thin Air
Find out what circumstances justify which appendectomy code.If you think appendectomy alwa... Read more
Modifier:
Modifier 62 Eases Your Multi-Provider Coding Dilemma
Your CPT should jive on both physician's notes, or else you can bid your claim goodbye.Whe... Read more
Reader Questions:
Modifiers 53, JW Leave No Procedure Wasted
Question: We perform Remicade infusions in our office. We typically report J1745 (for the ... Read more
Reader Questions:
278.01 and V Codes Prove Handy for Pre-Op Bypass Coding
Question: What ICD-9 code should I use for a pre-bypass EGD?Answer: Here's a step-by-step ... Read more
Reader Questions:
537.89 Secures Your Gastric Inlet Patch Claim
Question: What is the diagnosis code for gastric inlet patch?Answer: If you are referring ... Read more
Reader Questions:
44799 Is Your Last Resort for Fecal Transplant Coding
Question: How do I code for fecal transplants?Answer: You should use the unlisted code 447... Read more
You Be the Coder:
G0105 Proves To Be Irreplaceable For No-Finding Service
Question: My gastroenterologist performed a colonoscopy on a patient who is less than 50 y... Read more
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