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Gastroenterology Coding Alert
Gastroenterology Coding Alert
Gastroenterology Coding Alert - 2014; Volume 16, Number 12
CPT® 2015 Part 2:
New Lower GI Endoscopy Changes Echo the Upper GI Endoscopy Changes From Last Year
You’ll reduce the amount of times you use modifier 52 for GI procedures. If you ...
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Modifiers:
CMS Unveils 4 New Modifiers to Offset Unwarranted Use of 59
Judicious selection and not playing safe will be the key terms for future. Popularity ...
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ICD-10 Update:
Correct Complication Choices Will Conquer Ulcerative Enterocolitis Coding Obstacles
Get ready to learn changed disease terminologies. As the transition date to ICD-10 com...
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Readers Question:
Reporting Laser Tumor Ablation is Easier Than You Thought
Question: We encountered a colonoscopy patient recently who required a laser tumor ...
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Reader Question:
Check CCI Edits Before Billing Control of Bleeding
Question: Our physician just performed an EGD with biopsy and control of bleeding f...
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Reader Question:
Prove Medical Necessity for Unlisted Procedure Claims
Question: One of our physicians performed a colonoscopy on a Medicare patient with ...
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Reader Question:
Reporting Clip Placement as Separate Code is a Surefire Way to Trouble
Question: Our GI recently performed a colon polyp removal with a hot snare. Resecti...
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You Be the Coder:
Don't Get Vexed by Variceal Treatment
Question: What methods can gastroenterologists use to treat esophageal and gastric ...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 11
CPT® 2015 Part 1:
Non-Incisive Diverticulitis Drives New Esophagoscopy Changes
Bipolar cautery description gets a boot out of 43216 descriptor. This year, you saw a ...
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Screening:
Fine Tune Your Flexible Sigmoidoscopy Reporting With These 4 Tips
Order of codes presented in the claims makes a significant difference. Although Medica...
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Documentation:
Don't Let Poor Paperwork Come In the Way of Deserved Payouts
Get ready for even more specificity in ICD-10 next year. You may be able to choose dia...
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ICD-10 Update:
Malignant Esophageal Tumor Makes Your Reporting Easier Next Year
This update bucks the trend of expanding into multiple codes. Here’s a surprise:...
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Readers Query:
Control of Bleeding Takes Precedence in Colonoscopy
Question: Our GI just performed a colonoscopy on a Medicare patient for control of ...
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Reader Query:
Pay Heed to Payer Inputs for Smooth Payouts
Question: A patient had an EGD with injection and the provider used bicap cautery t...
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Reader Query:
History Matters When Reporting Screening Codes for Medicare
Question: We encountered a patient with a history of polyps. She is due for a surve...
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You Be the Coder:
Identify Biopsy Location for Accurate EGD/EUS Reporting
Question: We had a patient who underwent an EGD as well as an EUS. After our physic...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 10
Endoscopies:
Steer Clear of the Multiple-Endoscopy Limitations With These Pointers
Don’t get confused between multiple-procedure and multiple-scope rules. If you&r...
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Fee Schedule:
Your Best Path to Deserved Reimbursement Goes Through RVU method
Look for differences in local and national rates to avoid rejection. The Medicare Phys...
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ICD-10 Update:
Appendicitis Coding Remains Painless After Changeover
Other diseases of appendix get more accuracy from next year. Think of a gastroenterolo...
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Modifiers:
CMS Unveils 4 New Modifiers to Offset Unwarranted Use of 59
Judicious selection and not playing safe will be the key terms for future. Popularity ...
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Readers Question:
Presence of Earlier PEG will Decide PEJ Coding
Question: Our Gastro conducted a placement of a PEJ tube on a patient who already had a ...
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Reader Question:
Double Check Documentation for Type of Pouchitis
Question: One of our patients has been diagnosed with pouchitis. Which ICD-9 code s...
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Reader Question:
Accurate Number of Points Will Lead You to Accurate MDM Level
Question: Our gastroenterologist attended to a patient and noted the following: A...
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Reader Question:
Don't Ignore Anemia as a Precursor for Colonoscopy
Question: Can I use the diagnosis of iron deficiency anemia for a colonoscopy? The ...
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You Be the Coder:
Show Necessity for Multiple Polyp Removal Codes
Question: Recently, our gastroenterologist removed three polyps during a colonoscop...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 9
ERCPs:
Bust 3 Myths to Recoup the Maximum ERCP Reimbursement Your MD Ethically Deserves
If you’re relying only on modifiers 51 and 59, you could be missing out. If you&...
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GERD:
Keep These GERD Testing Options at Your Fingertips
Reporting multiple tests in one day will not get you in trouble. According to estimate...
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ICD-10:
Get Ready for Location Specificity in Reporting Crohn's Disease
Be sure to denote the complications or lack thereof in your fifth and sixth digits. As...
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Readers Question:
Modifier 78 is Your Friend for Post-Procedure Visits
Question: A Medicare patient returned to the endoscopy lab at 4 p.m. to control a b...
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Readers Question:
Justify Pre-operative Evaluation Billing with Accurate Diagnoses
Question: The general surgeon has asked us to determine whether one of our establis...
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Reader Question:
Paperwork Must Back Up 91035 Claim
Question: Our providers bill for the interpretation of the Bravo with 91035/26. The...
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You Be the Coder:
Make Best Use of Modifier 53 for Discontinued EGD Procedures
Question: Our GI performed a placement of naso-jejunal tube through the nose? Is CP...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 8
Hemorrhoids:
Follow These 4 Rules to Make Hemorrhoid Coding a Painless Affair
Type and precise method of treatment are keys to reimbursement heaven. Although hemorr...
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Dysphagia:
Debug Your Dysphagia Coding By Focusing on Type
Knowing the phase of the condition will point you in the right direction. You have to ...
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ICD-10:
These Colonic Polyp Codes will Come in Handy in 2015
Distinguishing between non-neoplastic and neoplastic polyps will save your bacon. Next...
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FBR:
Remove All Obstacles From Submitting a Perfect Foreign Body Removal Claim
Even dislodging the foreign body deserves a code. The way your coding progresses in ca...
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You Be the Coder:
Be Careful of Modifiers in Co-opted GI Procedures
Question: Our pediatric gastroenterologist scheduled a patient for an EGD with biop...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 7
GI Tube:
Target These Tube Placement, Replacement, and Maintenance Codes for a Picture Perfect Claim
Keep a sharp eye out for type of tube, kind of placement and inclusion of fluoroscopic g...
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E/M:
Don't Let Possible Level 4 and 5 E/Ms Opportunities Slip by With These Crucial HPI Facts
Resolve CPT®/Medicare conflicts when counting HPI elements. You could be losing out o...
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Colonoscopy:
3 Tips Connect the Correct Screening Diagnosis to Your Colonoscopy Code
Retain your V-codes even if the screening turns diagnostic. You should be following th...
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Training:
Keep Up Your Pace with ICD-10 Preparations
Whether you’ve been preparing or procrastinating, use the delay to get ahead of the ...
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Readers Question:
Mind Your Compliance Regulations Before Performing Gastric Emptying Scan
Question: My gastroenterologist wants to do a gastric emptying study in the office....
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You Be the Coder:
Look Closely at the Final Path Report Before Coding a Polypectomy
Question: Should we wait for the final pathology report before coding a polypectomy...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 6
CPT® Coding Strategies:
Ensure Maximum Ablation Reimbursement With This Expert Advice
Hint: Watch for CCI bundling for multiple procedures involving other tumor removal metho...
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E/M Coding Update:
Maximize Your Success With Subsequent Hospital Care Codes Using These 5 Steps
Incorporating each of these steps into your coding might better your practice’s re...
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ICD-10 Update:
Enjoy Simple Transition to K65.1 For Peritoneal Abscess Diagnosis
Hint: Don’t forget to identify the etiology and report it separately. When your ...
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Reader Question:
Look Towards Subspecialty When Billing Consults Under Same Tax ID
Question: We are in a large GI group all under the same tax ID. One of our ph...
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Reader Question:
Factor in Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app...
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Reader Question:
Understand "Calendar Date" to Avoid Coding Goof-ups
Question: The CPT® surgery guidelines state that the surgical package includes ...
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You Be the Coder:
Clear Confusion Over Reporting Different EGD Procedures by Different Clinicians
Question: Our pediatric gastroenterologist scheduled a patient for an EGD, coordina...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 5
CPT® Coding Strategies:
Conquer The Ins and Outs of Esophageal Dilations With This Expert Advice
Optimize payments by looking specifically for the use of fluoroscopy. If your clinicia...
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News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision. Th...
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ICD-10 Update:
Rejoice For a One-to-One Simple Transition For Portal Hypertension
Hint: Don’t forget to check documentation for additional complications. When rep...
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Reader Question:
Avoid Modifier Confusion For Separate Colonoscopy Beyond Global Period
Question: Our physician did a colonoscopy on a patient back in August 2013 during w...
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Reader Question:
Get Clarification on Billing Consultation Codes For Established Patients
Question: Apatient was last seen by our PA on 10/21/11 for diarrhea and abdominal p...
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You Be the Coder:
Don't Forget Additional Codes When Reporting Lynch Syndrome Diagnosis
Question: I am looking for the diagnosis code for ‘Lynch Syndrome”, als...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 4
CCI 20.1 Update:
Get Set to Face Fresh Slew of Edits to Esophagoscopy, EGD and ERCP Codes
Don’t forget to check CCI when reporting multiple endoscopy procedures together. ...
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ICD-10:
Enjoy a Smooth Transition on Your Way From ICD-9-CM to ICD-10
Get up-to-date expert tips from NGS to guide you. Entering into the new realm of submi...
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ICD-10 Update:
Go For a One-to-One Simple Transition to K28 ForGastrojejunal Ulcer
Hint: If cause is alcohol abuse, don’t forget to identify it additionally. When ...
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Reader Question:
Don't Forget to Check CCI Before Reporting Multiple ERCP Procedures
Question: Our physician performed multiple procedures on his patient, ‘43262&...
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Reader Question:
Base Hepatitis Screening Diagnosis Codes on Type of Risk Factors
Question: Can you let me know what the correct ICD-9 code for hepatitis screening t...
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You Be the Coder:
Use One Common HCPCS Code for Bacteriotherapy Irrespective of Payer
Question: I am looking at billing 44705 but I am not finding any RVUs for this code. F...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 3
CCI 20.0 Update:
Avoid Denials by Looking at CCI 20.0 When Reporting New EGD Codes
Look at CCI to see if the two ERCP procedures you are planning to report face bundling. ...
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Diagnosis Coding:
Delve Into Documentation to Confirm Diagnosis When Your Provider Fails to Pick One
Don’t hesitate to get back to your provider for details when you need them. You ...
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ICD-10 Update:
K56.3 Provides Simple One-to-one Transition For Gallstone Ileus
Hint: Distinguish from duodenal ileus to correctly nail the diagnosis. When you begin ...
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Reader Question:
Avoid Confusion About Diagnosis Codes For Screening Colonoscopies
Question: A patient who came in for colonoscopy has 1st degree family (mother) hist...
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Reader Question:
Get Clarification on Reporting Gastric Emptying Study
Question: My provider wants to do the gastric emptying study (78264) in the office. She ...
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Reader Question:
Avoid Location Based Assumption of Critical Care Codes
Question: After a patient with severe abdominal pain and hemoptysis in the ER was a...
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You Be the Coder:
Determine Patient Status For POS in Emergency Room
Question: Our physician was called to the ER to see a patient for dysphagia. He ass...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 2
CCI 20.0 Update:
Watch For Edits Bundling New Esophagoscopy Codes With Other Endoscopy Codes
Hint: Observe modifier indicator to see if you can unbundle the codes. While CPT® ...
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History How-To:
Point Your Provider in the Right Direction With These 5 History Tips
Beware of counting elements in more than one place. While recording patient history, y...
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ICD-10 Update:
K80.1 Offers Accurate Reporting Options For Cholelithiasis With Chronic Cholecystitis
Hint: Use different code sets when calculi are present in gall bladder and the biliary d...
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Reader Question:
Highlight These CCI Edits For Same Session Multiple Colonoscopic Procedures
Question: I code for an ASC and I often see situations where a colonoscopy is performed ...
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Reader Question:
Provide Entire Address, Not Generic Location in Block 32 of CMS-1500
Question: If you are billing home visits, 99341-99350, the place of service is 12. My qu...
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Reader Question:
Realize When to Use Modifiers For Unbundled CPT® Codes
Question: If I cannot find my two codes paired together in the CCI edits, how do I know ...
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You Be the Coder:
Get Clarified on DOS For Capsule Endoscopy
Question: In a previous issue of the “Gastroenterology Coding Alert” you hav...
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Gastroenterology Coding Alert - 2014; Volume 16, Number 1
CPT® 2014 Update:
Simplify Your ERCP Stent Reporting With New Comprehensive Codes
Hint: Don’t forget to report other procedures performed such as stone or debris re...
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News You Can Use:
These E/M Coding Errors Could be Tripping Up Your Claims
CMS finds 14.0 percent improper E/M payment rate. If the 2012 Medicare Fee-for-Service...
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ICD-10 Update:
K57 Expands To 10 Options For Accurate Diverticulitis Reporting
Hint: Choose from another additional four codes if anatomical location is not specified....
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Reader Question:
Understand When to Report CPT® Codes For Screening Colonoscopies
Question: When billing a screening colonoscopy for a high risk Medicare patient, what co...
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Reader Question:
Base Reduced Service Code on Original Intent
Question: My doctor did an incomplete colonoscopy and I’m not sure how to code it....
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Reader Question:
Choose Appropriate Code For Same Day Admission and Discharge
Question: One of our physicians admitted a patient to the hospital at 10:30 a.m., and la...
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You Be the Coder:
Determine EGD Code By Procedure Intent
Question: Our gastroenterologist recently performed an EGD on a Medicare patient that wa...
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