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Gastroenterology Coding Alert
Gastroenterology Coding Alert
Gastroenterology Coding Alert - 2019; Volume 21, Number 12
Compliance:
Find out How You Can Avoid This Gastroen¬terologist's Fate
Texas GI physician was found guilty in $16M fraud scheme. When your gastroenterologist ce...
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CPT® Coding:
Finish 2019 With Strong Responses to This Coding Quiz
Challenge yourself — and enter 2020 with a bang. As 2019 comes to a close and we prepar...
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Billing:
Don't Treat Family Members Until You Read This Billing Advice
Remember: Medicare has special rules when it comes to treating family members. Most medic...
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Reader Question:
Polish Your 'Z' Code Knowledge
Question: Our insurer is now rejecting claims if they see tertiary diagnoses mentioned in ...
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Reader Question:
Avoid Reporting Surgical, Diagnostic Endoscopy Codes Together
Question: Our GI physician performed a sigmoidoscopy for screening purposes. During the pr...
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Reader Question:
Look for Definitive Dx Before You Code
Question: Which diagnosis code should we report when the physician performs a colonoscopy ...
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Reader Question:
Get the Scoop on Medicare Secondary Payer
Question: Who is the Medicare Secondary Payer? Is that Tricare? Codify Subscriber Answer...
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You Be the Coder:
Timing Is Everything When Collecting From Patients
Question: Thank you for your Q&A last month about how front desk staff should be train...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 11
CPT® 2020:
Radiology Changes Abound for Gastroenterology Coders
Look for both new, revised codes effective Jan. 1. Ready for a new hemorrhoidectomy code ...
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Billing:
5 Tips Help You Boost Cash Flow
Master your accounts receivables and bring in more cash. If your GI practice has never ch...
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E/M Coding:
Visit Runs Longer Than Usual? Capture Pay With Prolonged Service Codes
Consider 3 tactics to account for extra time. You'll see it happen from time to time – ...
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Reader Question:
Know How to Handle Past-Due Balances
Question: A patient with a $60 past-due balance reports to the office for his annual check...
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Reader Question:
Look to 76872 for Rectal Ultrasound
Question: How should we code for a rectal endoscopic ultrasound? Mississippi Subscriber ...
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Reader Question:
Saline Injection May Not Be Billable
Question: Which code should I use to report an injection of saline into a polyp during a c...
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You Be the Coder:
Evaluate pH Testing Codes
Question: A patient complained of severe acidity, coughing, and chest pain for over two mo...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 10
Ablation Coding:
3 Tips Keep Your Ablation Claims Flowing
Remember to keep CCI edits at top of mind when selecting codes. For some specialties, cod...
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Compliance:
Gastroenterology Staff Under Fire for Exposing Patient Data
Tech incompatibility was at the root of the breach, staffers say. The more technologicall...
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Slash the Odds of Fraud Accusations With 10 Quick Tips
Tip: Follow Medicare's news updates. As emphasized in our article about patient privacy s...
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Reader Question:
Standby Service May Not Warrant Pay
Question: Our gastroenterologists sometimes stand by for other physicians in high-risk pro...
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Reader Question:
H. Pylori Dx Codes Span the ICD-10 Manual
Question: We often perform H. pylori tests – which diagnosis codes apply to these visits...
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Reader Question:
Evaluate Chronic Condition Recording Under E/M Guidelines
Question: When counting E/M history, can we use chronic medical conditions in place of ele...
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Reader Question:
Identify the Cirrhosis Diagnosis Code
Question: Our physician saw a 60-year-old male patient who presented with complaints of ab...
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Reader Question:
Know Whether Injection Justifies 43255
Question: The gastroenterologist attempted to perform an EGD with biopsy on a bleeding duo...
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Reader Question:
Use These Tips for Teaching Physician Services
Question: We currently have a medical student working with us at our clinic. In patient en...
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You Be the Coder:
How Should You Code G-Tube Replacement?
Question: An ambulance brought in a middle-aged male with a dislodged G tube from the nurs...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 9
CMS Audits:
Auditors Shine Light on Modifier Use with Discontinued Procedures
If you're a fan of modifiers 73 and 74, find out what RACs are reviewing. Every now and t...
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Incision And Drainage:
Differentiate Anal I&D from Rectal I&D Codes
When in doubt, query your providers. When you encounter a chart for anal or rectal incisi...
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Patient Privacy:
Are You Familiar with Incidental Disclosures?
6 expert tips help you minimize your disclosure risk. Although the HIPAA laws can be fair...
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Reader Question:
Is 99199 for No-Shows?
Question: We report 99199 to payers to bill for no-show patients. We've been doing this fo...
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Reader Question:
Is Incident-to On Its Way Out?
Question: We have two physician assistants at our GI practice, but we recently heard that ...
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Reader Question:
Is There an Order of Operations for CPT® Codes?
Question: We typically list the code with the highest RVU first on our claims when reporti...
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You Be the Coder:
Find out If You Can Carry Over EHR Notes
Question: In your article last month on time-based E/M coding, you mentioned the factors t...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 8
Diagnosis Coding:
Look for New History of Digestive Cancer Codes on Oct. 1
You'll find nearly 400 changes in the new ICD-10 code set. Just when you think your ICD-1...
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E/M Coding:
Consider This Your Definitive Time-Based E/M Coding Guide
Expert tips and real-life examples can bring you clarity once and for all. If time is mon...
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Prep Now for Big Changes to E/M Codes in 2021
Hint: If you report 99201 frequently, this change will have a massive effect on you. Does...
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Reader Question:
Know the Limits When Reporting Balloon Dilation
Question: Our physician performed an EGD on a patient with achalasia, and the notes s...
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Reader Question:
Confirm Duodenal Stent Codes
Question: Our gastroenterologist recently placed a duodenal stent during endoscopy. H...
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Reader Question:
Know When to Employ the 52 Modifier
Question: I'm coding an ERCP, and the gastroenterologist made numerous attempts with ...
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You Be the Coder:
How Should You Report Endoscopic Injections?
Question: Our physician will often inspect the submucosal area during upper and lower GI e...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 7
Hemorrhoid Coding:
4 Tips Help Guide Your Internal Hemorrhoid Coding
Tip: This is the time to thoroughly read the op note. You've heard the old adage “locat...
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Imaging:
Performing Endoscopic Ultrasounds With EGD? Tighten up Your Coding With These Tips
Selecting the right imaging codes may be simple – but knowing how to report them isn't. ...
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Patient Privacy:
Don't Let Patient Details Slip When Dealing With Others
Avoid giving away information to other patients. Keeping a HIPAA plan in place and checki...
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Reader Question:
Get the Scoop on Coding When Patient Isn't Present
Question: A patient's husband presented to talk about his wife's colonoscopy results and h...
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Reader Question:
Find out What Signs, Symptoms Entail
Question: We have a coder who wants to hold charts when patients don't have definitive dia...
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Reader Question:
Some Payers Bundle 99211 Into Specific Services
Question: The gastroenterologist saw a patient with GERD and started her on esomeprazole. ...
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You Be the Coder:
Can You Code for India Ink Tattooing?
Question: Our gastroenterologist used India ink to mark two lesions she removed by snare t...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 6
Screening Codes:
Eliminate Pre-Colonoscopy Screening Issues By Learning the Reporting Methods
Understand when E/M codes are your best option. Gastroenterology offices often see patien...
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GERD Coding:
Look to the 91010 Range for Your GERD Tests
Don't forget to document other treatments on manometry, pH study claims. When your gastro...
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Evaluation Codes:
Let These 3 E/M FAQs Get Your Coding on the Right Track
When it comes to office visits, it's not smart to play it safe. It's easy to focus your c...
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Reader Question:
Can You Report Double Dilation?
Question: Our physician performed an endoscopic PEG tube placement that required some extr...
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Reader Question:
Consider Date of Service for Acid Reflux Exams
Question: A primary-care physician referred a patient with severe heartburn to one of our ...
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Reader Question:
Get to Know Paralytic Ileus Diagnoses
Question: Our gastroenterologist examined a patient and ordered an x-ray of the abdominal ...
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You Be the Coder:
Seeking Esophageal Hemorrhage Code?
Question: In ICD-9, we had an option to report esophageal hemorrhage, but we can't find a ...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 5
Compliance:
RAC: Don't Forget That ASC Services Are Included in Consolidated Billing
Do you know how to handle consolidated billing patient issues? Whether you perform servic...
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ICD-10:
Get The Lowdown on These Diagnoses Commonly Seen in the ASC
From upper GI to colonoscopy, know which codes to report. Just like when you pe...
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ASC FAQs:
Can You Solve These 3 ASC Frequently-Asked Questions?
Hint: Modifier SG could be your friend. Suppose you bill Medicare when your gastroenterol...
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Reader Question:
It's HIPAA-Certified – Should You Trust That?
Question: Our office has purchased encryption software that claims to be “100-percent HI...
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Reader Question:
Nail Down Functional Dyspepsia Dx
Question: We recently saw a 55-year-old established male patient with complaints of heartb...
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Reader Question:
Get Clarity on Reporting Laryngopharyngitis
Question: Which diagnosis code should I use to report reflux laryngopharyngitis? Codify S...
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Reader Question:
Get the Scoop on Prolonged Service Coding
Question: We have a new gastroenterologist who seems very fond of adding prolonged se...
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You Be the Coder:
Know the Frequency for Initial Hospital Care
Question: Can you use inpatient initial care codes 99221-99223 more than once in the same ...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 4
G-Tube Coding:
Master These G-Tube FAQs
Replacing, removing, or inserting: Get the scoop on coding these services. GI patients of...
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Celiac Coding:
Seeing Celiac Patients? Keep Track of These Important Factors
Visits go beyond finding the right dx code – get the scoop here. If your gastroenterolo...
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Modifiers 101:
Solidify Your Modifier 25 Knowledge With This Quick Primer
Unsure where to start with this ubiquitous modifier? Read this first. Gastroenterology pr...
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Reader Question:
Make Sure Time Is on Your Side in Observation Care
Question: I read your recent reader question about same-day admission and discharge for pa...
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Reader Question:
MBI Numbers Don't Contain the Letter 'O'
Question: We've encountered some slight confusion when accepting the new MBI numbers on pa...
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Reader Question:
Look to ICD-10 Guidelines When Specificity Is in Question
Question: One of our gastroenterologists wants to see in writing where she has to document...
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You Be the Coder:
Differentiate Breath Test From Biopsy With H. Pylori Testing
Question: How do we code for H. pylori tests? Codify Subscriber Answer: The answer to th...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 3
Hemmorrhoid Coding:
Can You Answer These 3 Hemorrhoid Visit FAQs?
Hint: Know the difference between first- and second-degree hemorrhoids. In some cases, co...
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CCI Edits:
CMS Transmittal Revision Clarifies When Modifier 59 Applies to NCCI Edits
Let these facts help guide your modifier usage. If the modifier 59 coding rules seem to g...
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Auditing:
Is Your GI Practice at Risk of an Audit?
Check these benchmarks to get the scoop. Physician practices are increasingly in the spot...
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These Are the Big Five Focus Areas
GI coders should get to know five main areas involved in provider audits: E/M Cod...
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Reader Question:
Colon Resection With Hernia Involvement
Question: Our GI surgeon performed a laparoscopic partial colon resection with anastomosis...
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Reader Question:
Find out How to Handle New Physician's Billing Info
Question: A new physician started at our GI practice, but he hasn't received his insurance...
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You Be the Coder:
K56 Code Family Gets Very Specific
Question: I'm used to certain basic diagnoses that we face all the time, like intestinal o...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 2
Part B Reimbursement:
CMS: Gastroenterologists Logged $79 Million in Improper Part B Payments
Plus: Upper GI procedures were a source of problems. With so many compliance facts and re...
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Know The Coding Errors That CMS Evaluated
CMS identified $31.6 billion in total improper payments among providers during 2018, and b...
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ICD-10 Coding:
Check These Answers to Your 4 Top Signs/Symptoms Questions
Know which key phrases to seek in your physician's documentation. Whether you're new to G...
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Modifiers:
Using Co-Surgeon for PEG Tube? Consider Modifier 62
Hint: Modifier 80 is not always your best bet. When your gastroenterologist works with an...
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Reader Question:
Evaluate Email Coding Options
Question: What's the best way to document email exchanges between a patient's guardian and...
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Reader Question:
Confirm Status for Same Day Admit, Discharge
Question: One of our physicians admitted a patient to the hospital at 11:30 a.m., and late...
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You Be the Coder:
Check Ordering Dx for Screening FOBT
Question: How do we know whether to report a screening or diagnostic code for a fecal occu...
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Gastroenterology Coding Alert - 2019; Volume 21, Number 1
Recovery Audit Contractors:
RACs Scrutinize Surgical, Diagnostic Endoscopies at Same Session
Watch your endoscopic coding to stay off auditors' radar screens. You may think your gast...
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2019 Payment:
CMS Offers Reprieve from Big E/M Changes
Keep an eye on the upcoming changes, however. GI practices have been keeping a close eye ...
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Looking Ahead:
Here's What to Expect in 2021
Although CMS won't be instituting big changes to E/M coding and documentation when the cal...
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Patient Privacy:
Could Enteral Feeding Device Data Get Hacked?
Tip: Keep medical devices off the network if possible. You've tightened up your HIPAA pro...
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Reader Question:
What's the 411 on Modifier GT?
Question: I heard that there was an update about modifier GT but don't understand it....
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Reader Question:
Workers' Comp for GI Practice
Question: A 66-year-old patient presented to our gastroenterology practice for evalua...
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You Be the Coder:
Know the Documentation Rules When Coding Based on Time
Question: Thank you for your article last month about coding E/M visits based on time...
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