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Gastroenterology Coding Alert
Gastroenterology Coding Alert
Gastroenterology Coding Alert - 2015; Volume 17, Number 12
Injection Coding:
Energize Your Endoscopic Injection Reimbursements With 5 Simple Rules
Don’t miss opportunities to code multiple injections despite restrictions. If yo...
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E/M Corner:
Mark Your MDM Accurately to Maximize E/M Payment
Reporting the entire panel of tests upon confirmed diagnosis may land you in trouble. ...
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Modifier Mix:
Manage Your Multi-Provider Services With Modifier 62
Forfeit your payment if both physician’s claims don’t reflect the modifier u...
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Reader Question:
Reason to Stop Endoscopy Procedure Decides Modifier 52, 53
Question: Our gastroenterologist was performing a diagnostic EGD. While inserting t...
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Reader Question:
Limit Yourself to E/M for Buccal Colaris Testing
Question: A patient came in our office for a Buccal Colaris genetic test based on f...
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You Be the Coder:
Don't Reach Automatically for 45915 for Rectal Disimpaction in Office
Question: A physician is doing a manual disimpaction of the rectum under anesthesia...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 11
ICD-10 Coding:
Keep This Colonic Polyp Code Guide at Hand to Maximize Returns
Distinguish between non-neoplastic and neoplastic polyps will save your bacon. Colonic...
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CPT® 2016:
Get Ready to Welcome New and Revised Prolonged Services Codes Next Year
Revised codes can be added on to any service level, not just the highest. Change has ...
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GERD Testing:
Confront Esophageal Manometry Coding Challenges Head-On With This Refresher
Don’t use codes 0240T and 0241T for CY 2016. As a gastroenterology practice, you...
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Reader Question:
Don't Expect a Direct Diagnostic Code for Reporting Lynch Syndrome
Question: We are seeing Lynch syndrome cases. What are the best diagnosis codes to ...
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Reader Question:
Let the Actual Procedure Performed Guide Your Colonoscopy Codes
Question: A patient who had total colectomy and still had a rectal stump visited ou...
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Reader Question:
Do Not Combine 74360 With 43233 for Balloon Dilation >30 mm
Question: Our gastroenterologist recently performed an EGD on a patient with achala...
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You Be the Coder:
This Handy Guide Unlocks Your Transendoscopic Stent Placements Coding
Question: We received a case a few days in which the GI placed a duodenal stent dur...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 10
Endoscopy Clips:
Learn the Ins and Outs of Coding Gastro Clips With These Handy Tips
Cut out unnecessary steps when reporting endoscopic marking clips. Has your gastroente...
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Reimbursement Roundup:
Modifier PT Helps Your Practice Capture Screening-Turned-Diagnostic Colonoscopy Pay
Hint: Do not use the modifier PT when the service began as a diagnostic procedure. Alt...
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E/M Corner:
Back Up Your Level of E/M Services With Medical Necessity
Key: MDM and medical necessity are not the same. If you are reporting high-level E/M c...
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Reader Question:
Get RVU Priorities Right Before Billing Biopsies With Dilation
Question: Our GI recently performed an esophageoduodenoscopy with biopsies and esop...
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You Be the Coder:
Verify Medical Necessity for Successful Capsule Endoscopy Payment
Question: We recently purchased the PillCam™ Given Capsule technology to use ...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 9
Colonoscopy Pointers:
Use These Tips To Conquer Colonic Polypectomy Codes
Use biopsy codes for polypectomy in case of cold forceps. You are looking at a loss of...
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Screening Tests:
Frequency Rules and Risk Categories Call the Shots in Colonoscopy Screenings
Watch out: Medicare has specific requirements other payers might not follow. Colon can...
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RVUs Refresher:
Keep Up On PFS by Building a Comprehensive Understanding of RVUs
Break down the components of your payment. The Centers for Medicare and Medicaid Servi...
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ICD-10 News:
Medicare To Go Lenient on Diagnosis Coding Specificity Next Year
Avoid future problems by working with your physicians on added specificity. There is g...
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Reader Questions:
Use 99304-99318 Only for Ongoing Care Not For Nursing Home Consultations
Question: Recently, our gastroenterologist admitted a patient to the hospital direc...
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You Be the Coder:
Choose Between Guided and Unguided Insertion Before Coding Dilation
Question: Our physician performed an esophagoscopy on a Medicare patient before the...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 8
Upper GI Spotlight:
EGD Or Enteroscopy? Enlist These Tips For Reimbursement Success
Documented intention and medical necessity is the key to coding the procedure. You hav...
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Modifier Mashup:
Make Modifier 22 Pay You For That Extra Physician Work
Demonstrate the unusual nature of the procedure and ask for payment You can stand to a...
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Part B Payment:
Brace Yourself for Changes in Incident to Services, Gastro Pay Coming January
2016 could also usher in advance care planning payments. After a long interval, there ...
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Modifier Update:
CMS Admits to X(EPSU) Modifiers Not Being as Effective as Planned
Modifier 59 usage in its current form may be allowed until further notice. Many ...
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Reader Questions:
Colonoscopy With Polyp Removal? Look at the Scope Entry
Question: Our office has not one, but two, coding questions about removing polyps v...
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Reader Questions:
Track Updated CPT® and Medicare Codes Before Billing Colonoscopy
Question: Our gastro performed a colonoscopy with BICAP ablation of AVM for a patie...
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Reader Questions:
Ask for Payer Preference Before Modifying 43248 and 43239 With 59
Question: Our gastroenterologist performed an EGD with dilation and also biopsy on ...
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You Be the Coder:
Call On Mod 52, 53 for Rescue in Incomplete ERCP Procedures
Question: I’m coding an ERCP, and the doctor made numerous attempts with the ...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 7
Fecal Testing:
Fortify Your Payment for FOBT Services With These Tips
Get your patient involved before billing 82270. Coding for your gastroenterologist&rsq...
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Modifier Mashup:
Preserve Your Postop Procedure Reimbursement With Modifier 58
Get the staging right by scanning the op notes. Choosing the right modifier to represe...
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ICD-10 Update:
Get Ready to Assign R10 codes for Abdominal Pains
What is the trick for painless reporting of abdominal pain? Hint: The symptom is simpl...
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ICD-10 News:
Enjoy Extended Coverage With Transition Period Proposal
HHS to prove readiness and provide 18 months cover from denials. Get ready for the lat...
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Reader Questions:
Let Technique Decide Varices Treatment Codes
Question: Our gastroenterologist recently performed an esophagoscopy and found vari...
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Reader Questions:
Report Infectious Pouchitis With Supporting Dx Codes
Question: What diagnosis code should I use for pouchitis? Does the ICD-9 code chang...
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You Be the Coder:
Don't Let Separate DOS Confuse Your Paracentesis Claims
Question: The gastroenterologist performed paracentesis on a patient to drain fluid...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 6
Procedure Coding:
Level up on the Latest Lower GI EUS Coding With These 4 Pointers
Go through the new Medicare allowed codes before reporting latest 2015 codes. As...
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CPT® 2015:
Clear the Confusion on 'Abridged Colonoscopy' Coding with These Tips
Look at new ‘decision tree’ to get clear choices. How to code a colonoscop...
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ICD-10 Countdown:
Train Your Sights on October ICD-10 Transition With These 6 Steps
Tip: Practice ‘dual coding’ to land on your feet running after October. Wi...
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Readers Queries:
Specify the Site of Stricture Before Reporting EGD With Bougie Dilation
Question: A patient recently visited our office with a complaint of dysphagia. Our...
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Readers Queries:
Biopsy Takes First Priority for Multiple Colonoscopy Procedures
Question: Our physician recently performed a colonoscopy with polypectomy and also ...
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Readers Queries:
Avoid Reporting Screening Codes for Colonoscopy Based on Symptoms
Question: A 48-year-old patient complaining of chronic heartburn, cough, and cramps...
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Readers Queries:
Visit Revised Codes Before Reporting Lower GI Codes for 2015
Question: Our surgeon performed a colonoscopy through a stoma for a patient with a histo...
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You Be the Coder:
Report Biopsy with EGD According to Methods Not Sites
Question: The documentation states that the gastroenterologist performed an EGD and...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 5
Procedure Coding:
Answer 3 Questions to Ace Your Upper GI EUS Claims
Report the EGD EUS only if your gastroenterologist has documented this procedure. ...
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Medicare News:
Lock In On Lower GI Procedures for Medicare With New 'G' Codes
Heed non-recognized CPT® codes before coding procedures. Maybe you’re thrill...
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Appendectomy Coding:
Avoid Raising Appendectomy Claim Red Flags With These Tips
Heads up: You have more options besides 44955. You may consider appendectomy as a bund...
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Readers Questions:
Read Your Local Payer Rules Before Reporting Botox Injections for Anal Fissures
Question: We have a new gastroenterologist who recently advised Botox to a patient ...
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Reader Question:
Double Check Colonoscopy CPT® Codes Before Reporting for Medicare
Question: Recently, during a colonoscopy our physician removed polyps from descendi...
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You Be the Coder:
Dig Out Different Diagnosis Codes Before Reporting E/M With Screening Colonoscopy
Question: A high-risk patient came in for a screening colonoscopy to our gastroenterolog...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 4
Infection Testing:
Best Practices Keep Your H. pylori Test Coding on Track
Tip: Heeding local payer criteria for testing is crucial for getting paid. If you gast...
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Hepatitis Screening:
Handle Hepatitis C Screening Smoothly With New HCPCS Code
Repeated screening is no longer taboo for high-risk patients. You’ll find your p...
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ICD-10 Update:
Get Ready to Discover Other Symptoms Before Coding IBS in ICD-10
IBS code shares the ICD-10 code address with spastic colon. Presence of diarrhea sympt...
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ICD-10 Prep:
Gear Up for the ICD-10 Shift With Training Programs and Testing
Participate in the upcoming testing drives in March and June to check your preparedness....
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Reader Questions:
Double Check Payer Accepted Dx Codes to Avoid Kickbacks
Question: Our physician performed stent exchange on a patient with stricture of the...
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Reader Questions:
Pause Briefly Before Coding Repeat Consults
Question: How often can we report consult codes for the same patient? Our gastroent...
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You Be the Coder:
Hone Your Hepatitis Injection Reporting With This Ready Reckoner
Question: Our gastro office is getting queries about hepatitis A and hepatitis B vaccina...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 3
Consult Services:
5 Tips Help You Ace Your Inpatient Consult Coding
You can bill initial visits again on re-admission of a discharged patient. When your g...
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Modifier Alert:
Master These Modifier 52 and 53 Differences for Deserved Dollars
Forego modifier 53 when the patient voluntarily decides to stop the procedure. When yo...
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ICD-10 Update:
Proceed to Painless Reporting of Abdominal Pain With R10 Codes
New codes introduced give more options for colic and severe abdominal pain. What&rsquo...
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Readers Question:
Don't Abandon Modifier 59 Completely for X(EPSU)
Question: Is modifier 59 still valid as modifier for colonoscopy CPT® codes 453...
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Readers Question:
Control of Bleed Pays Only as a Primary Procedure
Question: Our gastroenterologist just attended to a Medicare inpatient and performe...
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Reader Question:
Unlisted Code is the Last Resort for Colonoscopy Procedures
Question: Our GI performed a colon screening through stoma for a Medicare patient w...
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You Be the Coder:
Modifier 22 Comes to the Rescue in Complicated Excision Procedures
Question: Our GI was performing a polyp excision recently and he documented the pol...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 2
Procedure Coding:
3 Tips Help You Ratchet Up Your Sigmoidoscopy Accuracy
Knowing the correct situations to report control of bleeding will help avoid denials. ...
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Modifier Update:
Modifier 33 is Your Key to Unlocking Screening Denials
Not all payers are on board, so keep your eyes peeled for individual LCDs. If you want...
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E/M Pitfalls:
Avoid These Top E/M Coding Traps to Prevent Claim Rejection
Adept handling of documentation will ensure reimbursement nirvana. You may be an old h...
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ICD-10 Update:
Screening Colonoscopy Gets a Direct Crossover
Medical necessity is pivotal for preventive service. With the implementation date of O...
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Readers Question:
Extent of Scope Insertion Decides EGD Codes
Question: Our GI performed attended to two patients for esophagogastroduodenoscopy ...
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Readers Question:
Sigmoidoscopy + Hemorrhoidectomy With Ligation Gets a New Address
Question: Our GI was performing a flexible sigmoidoscopy on a patient in our office...
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Reader Question:
Avoid Mistaking Specimen Collection for Biopsy
Question: During a patient’s routine screening colonoscopy, our gastroenterol...
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You Be the Coder:
Site of Analysis is important in Reporting C-14 Breath Test
Question: Our gastroenterologist recently saw an established patient with prolonged...
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Gastroenterology Coding Alert - 2015; Volume 17, Number 1
GI Tract Imaging:
Smoothen Out Your Capsule Endoscopy Wrinkles With These Tips
Watch out for new code 0355T for colon imaging. Your gastroenterologist has just...
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Don't Let Modifier Glitches Sideline Your Capsule Endoscopy Claims
Ask for pre-authorization from the carrier to repeat a capsule study due to previous tec...
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Audit Alert:
Heed These Documentation Cues to Avoid Audit Gaps
Pass the four-pronged test employed by CERT reviewers. You don’t want to be on a...
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ICD-10 Update:
Direct Matches Simplify Your Noninfectious Gastroenteritis Reporting
Focus on the cause for arriving at the right ICD-10 code. If your gastroenterologist d...
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Readers Question:
Go to G0472 for Reporting Hepatitis C Screening
Question: Our GI just saw a Medicare patient and advised her to undertake a hepatit...
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Readers Question:
Check Off These Conditions to Justify Consult Visit
Question: Our GI attended to a new patient. She said that she was advised by her PC...
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Reader Question:
Fearlessly Report EGD and PillCam® Capsule Together
Question: Can we bill for a capsule placement by doing an EGD in an ASC and get rei...
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Reader Question:
Check Payer for Exact Rules on Botox Injection Rules
Question: My physician’s documentation states that he performed esophagoscopy...
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You Be the Coder:
Watch Out For 90-Day Global for Hemorrhoid Procedure
Question: Our gastroenterologist saw a patient in the office visit with subsequent ...
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