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Gastroenterology Coding Alert

CPT® 2017:
PFS to Eye Your EGD Biopsies Payment In 2017
Get ready to receive 14 percent less payment for your work on 43239. As you usher the ... Read more
ECRP Coding:
Master These 4 Areas in ECRP Coding
Choose wisely from 43264, 43262, and 43277 for your bile duct procedures. Are you conf... Read more
ICD-10 Update:
Quick Quiz: Test Yourself on These New Gastroenterology ICD-10-CM Codes
Use this quiz to identify where you need to focus your learning. Accurate ICD-10 codin... Read more
Sigmoidoscopy Screening:
Hold On To Your Sigmoidoscopy Claims with These Tips
Know what to report when 45330 turns therapeutic. Are you sure you are getting optimal... Read more
Reader Question:
Solve the EGD Coding Dilemma
Question: The provider performed EGD, and identified achalasia. He then performed d... Read more
Reader Question:
Tackle Coding For EGDs with Ablation
Question: While performing EGD, the provider found multiple 2 to 7 mm NON bleeding ... Read more
Reader Question:
When Can You Bill For NG Removal?
Question: The provider removed an NG tube as he observed that the tube was in the e... Read more
Reader Question:
How Do You Code For Snare Removal And Ablation Of The Same Polyp?
Question: The provider identified a 10 mm semi sessile polyp in the ascending colon... Read more
You Be the Coder:
Don't Give Up On Incomplete Colonoscopy Reimbursement
Question: The provider performed a colonoscopy for removal of a foreign body within... Read more
Moderate Sedation:
Get Ready to Take a Giant Leap Forward in Moderate Sedation Coding
Learn the ins and outs of 99152 vs. GMMM1, and more. Wondering what codes to report wh... Read more
MACRA Final Rule:
Conquer MACRA One Step at a Time
Eliminate penalties - report at least one of 16 GI-specific measures in transition year ... Read more
ICD-10-CM Update:
Zero In On Abdominal Pain Coding With Options from R10 Category
Choose carefully between R10.84 and R10.817 for generalized pain vs. tenderness There ... Read more
Reader Question:
Crack Down Liver Elastography with This Code
Question: My gastroenterologist performed a liver elastography using mechanical she... Read more
Reader Question:
Know How to Code For Coloproctostomy with Colostomy
Question: The GI surgeon performs coloproctostomy with colostomy for a patient with colo... Read more
Reader Question:
Can You Report 91040 With No Provocation? Find Out
Question: Our GI performs an esophageal balloon distension study on a patient who c... Read more
You Be the Coder:
Know How to Code For Snare Removal of Multiple Polyps
Question: Our provider examines the colon and rectum using a colonoscope and perfor... Read more
CPT® 2017 Update:
Get the Pulse of CPT® 2017 Final Updates for Gastroenterology
Be ready for removal of conscious sedation from 43235, 43260, and many more changes&hell... Read more
ICD-10 Update:
Master the New ICD-10 Codes for Intestinal Infarcts, Hepatic Failure and Pancreatitis
New options for pancreatitis let you code based on presence of necrosis October is her... Read more
MACRA Update:
Make the Most of the Four "Pick Your Own Pace Options" From CMS
Start work now on colonoscopy and GERD, says AGA. Washing away all the speculations ab... Read more
Reader Question:
Explore Coding Options in Endoscopic Ultrasound (EUS) Along With FNA
Question: The provider performs endoscopic ultrasound with optical endomicroscopy (... Read more
Reader Question:
Tread Carefully With Sclerotherapy for Esophageal Varices
Question: The doctor performs sclerotherapy for esophageal varices. How do we repor... Read more
Reader Question:
Hit the Right Code for EGDs with Dilation and Biopsy
Question: Our surgeon performed an EGD that required dilation for access. Upon exam... Read more
Reader Question:
Explore Your Coding Options for Gastroesophageal Reflux Test
Question: A fifty year old male patient, complaining of heart burn, is diagnosed as... Read more
Reader Question:
Pick the Right Code for Transoral Esophagoscopy with Specimen Collection
Question: The provider views the esophagus by means of rigid endoscope through the ... Read more
You Be the Coder:
Know How to Code For Incomplete Colonoscopy
Question: A provider performs diagnostic colonoscopy. During the procedure, he is a... Read more
News You Can Use:
CMS To Re-Evaluate GI Procedures That Include Moderate Sedation
Get ready for six new exclusive codes in 2017. Your endoscopy reimbursement could look... Read more
ICD-10 Update:
Take Note of the New Codes for Malabsorption, Megacolon and IBS
Here’s why simply documenting “IBS” won’t work. When it comes ... Read more
Policy:
There's More to MACRA Implementation Delay Stories than Meets the Eye
Get answers to MACRA delay: the truth, the timing, and the options CMS is doling out. ... Read more
Reader Question:
Spot the Right Candidate for Colorectal Cancer Screening
Question: What are the criteria to consider a person as having high risk for colore... Read more
Reader Question:
Use the Category III Codes For Esophageal Manometry No More
Question: Which codes do we use to report esophageal motility studies with interpre... Read more
Reader Question:
Know What All Comes Under CRC
Question: What all comes under preventive colorectal cancer (CRC) screening service... Read more
Reader Question:
Maximize Your EGD Pay with Modifiers 52 And 53
Question: What is the correct way to report EGD procedures making appropriate use o... Read more
You Be the Coder:
Prolonged Services for Gastroenteritis
Question: A 50 year old male has persistent vomiting and gastroenteritis. On assess... Read more
Reimbursement/Policy:
Master the 4 MIPS Components That Hold the Keys to Success
Your 2017 performance could get you 4 percent incentives in 2019. Is surviving MACRA (... Read more
Coding/Policy:
Get All Your Answers for Incident-to Services
Bill “incident-to” for a previously established problem. Just how updated ... Read more
ICD-10 Update:
Grab the 2017 Diagnosis Changes for Gastroenteritis and Colitis
K52.82 now includes codes for 4 new types of proctocolitis. ICD-10-CM coding can be a... Read more
Reader Question:
Earn Well for Advanced Care Planning Codes
Question: The provider spent an hour discussing advanced care planning with a patie... Read more
Reader Question:
Report Category III Codes for Magnetic Band on Esophageal Sphincter
Question: The doctor inserted a magnetic band and placed it externally on the exter... Read more
Reader Question:
Work on Endoscopic Mucosal Resection Claims
Question: Our claim for endoscopic mucosal resection got rejected. What could be th... Read more
Reader Question:
Use the Right Modifier for Incomplete Colonoscopies
Question: A patient is prepared for total colonoscopy. However, during the procedur... Read more
You Be the Coder:
Get Paid for 43239 and 43248 for EGD Claims
Question: How do we get a claim for 43239 through when filed along with 43248?... Read more
Coding/Reimbursement:
Master Screening Colonoscopies in a Jiffy
Keep in mind the frequency rules to help pick the right codes. Are you mystified by th... Read more
Policy/ Reimbursement:
MACRA Holds a $ 34 Million Promise for Gastroenterologists
Solo practices to be hit hard, large practices to flourish, and more … Tighten ... Read more
ICD-10 Update:
Prepare Yourself for the ICD-10 Updates In 2017
Changes for GIs to postprocedural hematoma, Hodgkin’s lymphomas, and more. Sorti... Read more
Reader Question:
Know How to Secure Your Pay for Anesthesia Services
Question: We have been repeatedly getting denials for our anesthesia services. What... Read more
Reader Question:
Same Day, Separate Session Means Modifier 79
Question: A patient who initially had a colonoscopy with snare technique (45385) ma... Read more
Reader Question:
Report EGD With Modifier 59 for Bleeding Elsewhere
Question: The provider cauterized a bleeding ulcer in the stomach and took a biopsy... Read more
Reader Question:
Bill for Multiple Services on the Same Day
Question: In our hospital, a patient may need to visit various healthcare professio... Read more
You Be the Coder:
Colonoscopy Won't Work for Hemorrhoids, Acute Diarrhea
Question: What are the limitations of colonoscopy (44388-44397; 45355- 45392)? De... Read more
ICD-10:
Size Up These 7 Gastroenterology Changes Planned for ICD-10-CM 2017
Get ready for more specific pancreatitis codes. The CDC has posted a preliminary list ... Read more
PEG Tube Removal:
Only Removing PEG Tube? Focus on E/M Codes
Find out why 43247 just won’t do you any good. If you’ve asked yourself fr... Read more
Modifiers:
Draw the Line Between Modifiers 51, 59
Heads up: Medicare prefers you don’t use one of these modifiers at all. Many co... Read more
Reader Question:
Upper EGDs Have 0 Global Days
Question: My physician plans to perform a repeat EGD on a patient with significant ... Read more
Reader Question:
Here's What to Do if Your Payers Reimburse 99360
Question: Our surgeons sometimes “standby” for other surgeons in some h... Read more
Reader Question:
Attempted EGD Warrants Modifier 53
Question: The GI attempted an EGD on a patient with primary tongue carcinoma who ha... Read more
Reader Question:
Bolster Placement? Prepare to Use Outpatient E/M
Question: I’ve heard about PEG tube bolster replacement, and curious about ho... Read more
Reader Question:
Apply 45990 For Rectal Exam With Anesthesia
Question: I can’t seem to find a proper CPT® code for this: The surgeon u... Read more
Reader Question:
For APC During EGD, Report 43255
Question: How should I report an EGD with Argon plasma coagulation performed by our... Read more
You Be the Coder:
Looking for Code for Tattooing Polyp? Do This
Question: I heard CPT® has a different code for colonoscopies performed through... Read more
Crohn's Disease:
Capture the Full Crohn's Coding Picture With Diagnosis and Management, Treatment Codes
Your ICD-10 code will depend on location. Your Crohn’s disease (ileitis or regio... Read more
Coding Strategies:
Hone Your H. Pylori Testing With This Expert Advice
Check method of choice to guide your coding. When your physician suspects a patient of... Read more
ICD-10:
2 Scenarios Test Your Knowledge of Barrett's Esophagus
Look at dysplastic changes to guide your code choice. Barrett’s esophagus is a c... Read more
Reader Question:
How to Code Different Polypectomy Techniques
Question: Our gastroenterologist recently performed a colonoscopy. During the proce... Read more
Reader Question:
When Should Hospitals to Use Same CPT® Code? Find Out
Question: We have been getting denials from Medicaid and other insurance companies ... Read more
Reader Question:
Report 74270 For Barium Enema
Question: My gastroenterologist ordered barium enema for a 4-year-old male patient ... Read more
Reader Question:
Billing 99212-25 and 43202 Will Require Stellar Documentation
Question: A patient presented to the office for his scheduled esophagoscopy with biop... Read more
You Be the Coder:
Discontinued Colonoscopy Procedure
Question: Our gastroenterologist performed a diagnostic colonoscopy but was unable ... Read more
Upper Endoscopy:
Pick Up an Ethical $400 By Applying the Lessons from This EGD Op Note
Tip: “Sample collection” is different from an actual biopsy. When your ga... Read more
ICD-10:
Your Diagnoses Will Prop Up Your G Codes for High Risk Colonoscopies
A hemorrhoid’s location should lead you to the appropriate ICD-10. Want to get y... Read more
Modifiers:
Another Trip to the OR? See If The Visit Warrants Modifier 58
Clue: If you’re coding a complication procedure, go with a different modifier. W... Read more
Reader Question:
A 'Healthy' Appendectomy Won't Add to Your Bottom Line
Question: I heard Medicare and most other payers will not pay separately for the re... Read more
Reader Question:
Attempted EGD? Look to Modifier 53
Question: The GI attempted an EGD on a patient with primary tongue carcinoma who ha... Read more
Reader Question:
Acute Diarrhea Won't Support Colonoscopy
Question: What are the limitations of colonoscopy (44388-44397; 45355- 45392)? De... Read more
Reader Question:
Resolve Your Colonic Hemorrhage Doubts
Question: Our gastroenterologist diagnosed a patient with significiant lower gastro... Read more
Reader Question:
Reflect Personal History With Z86.010
Question: If the physician does not state the type of polyp as adenomatous for a &l... Read more
You Be the Coder:
Is There Such A Condition As NERD? Find Out
Question: My physician’s notes indicated the patient, who was in for an EGD, ... Read more
Procedure Coding:
5 Q&As; Take the Pain Out of Hemorrhoid Procedure Coding
Location takes precedence over all other conditions, even number. While reporting hemo... Read more
Part B Update:
You Are Not Bound to Accept Each and Every New Medicare Patient
MACs also clarify doubts over “incident to” and “shared/split” s... Read more
Compliance Matters:
Count on ABNs to Salvage Your Reimbursement for Uncovered Services
Keep records of unsigned ABN on file even if patient does not sign and return the ABN be... Read more
Readers Question:
Extent of Scope Decides Endoscopy + Ablation Code
Question: How do I code this procedure? The notes show that the physician performed... Read more
Reader Question:
Watch Time Restrictions Closely Before Billing Screening Colonoscopy
Question: We recently had a Medicare NP come in to the office for a screening colon... Read more
Reader Question:
Learn When to Bill for PA Services
Question: A patient visited the office for hepatitis C treatment follow-up. After c... Read more
You Be the Coder:
Don't Pass up a Potential $400 Payout With 44388 + 45330 Combo
Question: A patient required both a flexible sigmoidoscopy and a colonoscopy throug... Read more
Procedural Coding:
Check These 4 Pre-Requisites for a Perfect Proctosigmoidoscopy Claim
Follow Endoscopic family rules for any therapeutic services during the procedure. Your... Read more
Medicare Fees:
Prepare for Physician Pay Cuts in 2016 MPFS Recommendations
Endoscopy sees maximum fee cuts. If you are rejoicing over the news that the Sustainab... Read more
E/M Errors:
Take Corrective Action Fast to Reduce Possibly Inflated E/M Claims that CERT has Flagged
Even NPP claims are equal culprits. Audit studies have always found evaluation and ma... Read more
Readers Question:
Include Tube Removals as Part of E/M Services
Question: Our gastroenterologist performed EGD on a patient on one day and colonosc... Read more
Reader Question:
Don't Drop 'Z' Code for Screening Colonoscopy
Question: Our surgeon performed a screening colonoscopy for a Medicare patient, but... Read more
Reader Question:
ERCP + Injection Therapy for Papillotomy Most Likely a No No
Question: How should I report an ERCP (endoscopic retrograde cholangiopancreatograp... Read more
You Be the Coder:
E/M Service Before a Procedure? Choose the Modifier Wisely
Question: We have many cases where the physician decides to perform a procedure lat... Read more
Cancer Screening:
Cross Out 4 Checklist Items to Claim Colorectal Cancer Screening Payment
Look out for screening tests that are not covered for payment. Billing colorectal c... Read more
Part B Payment:
Check How CMS Final Payment Rules Affect Your Practice in 2016
Here’s why you should prepare for deeper pay cuts. CMS released its Final Rule o... Read more
Billing Corner:
Confirm 'Established Plan of Care' to Avoid Rejection of NPP Services Billing
Definition of new condition is crucial to distinguish incident-to services. If your ga... Read more
Reader Question:
Reporting Dilation With Stent placement is a Strict No No
Question: Our GI recently performed the following procedure. How should I code it? Pro... Read more
Reader Question:
Stagger the Diagnosis Codes Carefully When Reporting Screening + Treatment
Question: While performing a screening colonoscopy, our GI found polyps and treated them... Read more
You Be the Coder:
Formalin Infusion During Sigmoidoscopy May Justify Prolonged Services Codes
Question: A gastroenterologist in our practice recently treated a patient with a diagnos... Read more
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