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Gastroenterology Coding Alert

Enema Coding:
Avoid Radiology Codes for Therapeutic Enema Administration
Hint: You'll want to document your E/M services thoroughly for these visits. Although som... Read more
ICD-10 Coding:
Pinpoint the Right Codes for Nondefinitive Diagnoses
Sometimes Z codes will be your best bet. When your gastroenterologist sends out a diagnos... Read more
Modifiers:
Perfect Your Modifier Skills With 12 Quick Tips
Remember: The GT modifier isn't a good replacement for modifier 95. Your gastroenterology... Read more
You Be the Coder:
Can You Differentiate PEG Tube Removal Options?
Question: Our gastroenterologist removed a percutaneous endoscopic gastrostomy (PEG) tube ... Read more
Reader Questions:
Check Date of Service for Video Capsule Endoscopy
Question: When coding for a video capsule endoscopy (91110), should we bill for the date t... Read more
Reader Question:
Get the Scoop on EGD Coding
Question: A patient complained of pain in swallowing, acidity, and regurgitation at times.... Read more
Reader Questions:
PHI Goes Beyond Patient’s Medical Record
Question: Is there more to protected health information (PHI) than just a patient's medic... Read more
2021 E/M Coding:
Test Your Mastery of 2021 E/M Changes
2021 is right around the corner, so it's a good time to brush up. Ever since the news bro... Read more
ICD-10 Coding:
Perfect Ulcer Coding With a Firm Grasp of These ICD-10 Tips
Acute, chronic, hemorrhaging, and more criteria will guide your coding choices. Gastroen... Read more
Nurse Practitioner Coding:
Are Your NPs Reporting High-Level E/M Services Properly?
A new report says the improper payment rate for 99204 and 99205 is in the double digits. ... Read more
You Be the Coder:
Can You Report AWV With E/M?
Question: Thanks for your article on annual wellness visits last month. We are finding tha... Read more
Reader Questions:
Get the Scoop on Encrypting
Question: Does electronic protected health information (ePHI) have to be encrypted to be H... Read more
Reader Questions:
Yes, You Can Bill Inpatient Visits Based on Time
Question: Our gastroenterologist saw a colitis patient in the hospital and did not maintai... Read more
Reader Questions:
Definitive Dx More Important Than Signs, Symptoms in Most Cases
Question: One of our gastroenterologists is capturing general complaints, like malaise and... Read more
Coding Quiz:
Test Your Lower GI Coding Skills With 3 Questions
Some anatomical knowledge is essential before you can code these correctly. The lower GI... Read more
Annual Wellness Visits:
Avoid These Common Errors to Collect for AWV Services
Don't forget to include a preventive screening schedule, Medicare reps say. Gastroenterol... Read more
Reimbursement:
CMS Proposes Steep Cuts for GI Practices in New Fee Schedule
But telehealth expansions could last into 2021. The upcoming changes to the E/M code set ... Read more
E/M Visits:
Get Ready for the 2021 E/M Changes With These 6 Tips
Hint: Know how the definition of “stable” may change. As gastroenterology practices a... Read more
You Be the Coder:
What Constitutes a Nurse Visit?
Question: An established patient with anemia visited our office to receive a vitamin B-12 ... Read more
Reader Questions:
Third Party Typically Bills for Cologuard
Question: We recently started performing Cologuard™ tests and we aren't sure how to repo... Read more
Reader Questions:
Count the Clock for Critical Care
Question: Which code should we report if the physician sees a critically ill patient for l... Read more
Weight Loss Management:
4 Tips Lead You to Obesity Counseling Success
Hint: You won't always be able to report 99401 with an E/M. When patients present to your... Read more
Compliance:
Shore up Your Telehealth Documentation to Avoid Audit Mishaps
Reviews are on the way for telehealth services you provided during the PHE. When the gove... Read more
Don’t Forget to Include These Factors in Your Telehealth Documentation
To ensure that your telehealth and phone visits stack up against provider audits, ensure t... Read more
Noncovered Services:
Get to Know the Nuances of New ABN
Prepare your red pen when particular ABN situations arise. CMS has updated the Advanced B... Read more
Reader Questions:
Get the Scoop on Rectal Polyp Excision Coding
Question: Our physician excised a 6 mm rectal polyp at the dentate line laterally via elec... Read more
Reader Questions:
Pay Attention to Incident-to Supervision Rules
Question: If the physician and a nurse practitioner are in contact over the phone —... Read more
Reader Questions:
Can You Diagnose ‘Corkscrew Esophagus?’
Question: The physician performed an EGD and described the distal esophagus as “app... Read more
You Be the Coder:
Does GJ Tube Replacement Without Fluoro Justify Unlisted Code?
Question: We've had some issues when we report unlisted codes 43999 or 44799 to descr... Read more
ICD-10:
Latest Edition of ICD-10 Delivers New Codes for Esophagitis, Reflux
You'll now be able to specify when patients experience bleeding and when they don't. GI c... Read more
Accounts Receivable:
4 Tips Help Your GI Practice Stop Leaking Money
You can bring in more reimbursement by adhering to a few important strategies. If your ga... Read more
E/M Coding:
Nail Down Answers to Your Most Pressing E/M Issues
Are your templates dragging down your code accuracy? Every practice wants to submit cle... Read more
Recapture Lapsed Patients to Tap Additional Revenue
Every medical practice has patients who stop coming in, even though they may have conditio... Read more
Reader Questions:
Should You Differentiate Heartburn, Epigastric Pain?
Question: I have a question about epigastric pain versus heartburn. We have one physician ... Read more
Reader Questions:
Get a Handle on EGD Denials
Question: We performed an EGD on a patient whose X-ray showed a sliding hiatal hernia, and... Read more
You Be the Coder:
Is This a New Patient?
Question: We are aware of the new patient rules for E/M visits, but this situation is a ne... Read more
Compliance:
Watch Out for This Common Coding Trap When You Perform Imaging
Recovery audit contractors could soon be on the hunt for unbundling issues. Your coding p... Read more
E/M Coding:
Straighten Out Your HPI to Accurately Report E/M Claims
Bust these myths to appropriately convey the history of present illness. Your GI practice... Read more
Billing:
Check This Advice to Tune up Your A/R Processes
Don't let even a single claim slip through the cracks. As the coronavirus pandemic contin... Read more
Here's What Your Financial Policy Should Include
An important element in your billing program is a financial policy that all patients must ... Read more
Reader Questions:
CMS Requires Physician to Be Onsite for 99211
Question: We reported 99211 for a nurse visit with a Medicare patient when the gastro... Read more
Reader Questions:
Don't Eliminate History, Exam Components in January
Question: Since history and exam will no longer be key components for determining the... Read more
You Be the Coder:
Can You Report More Than 1 Consult?
Question: How often can we report consult codes for the same patient? We saw a patien... Read more
ICD-10 Coding:
Can You Master This Diagnosis Coding Quiz?
Hint: Know when confirmed diagnosis takes precedence. No matter how much time you dedicat... Read more
Telehealth Coding:
Maximize Your Telehealth Success With 3 Quick FAQs
Know the POS rules to ensure payment. If you've been performing a multitude of telehealth... Read more
Modifiers:
Check These 7 Facts About Common E/M Modifiers
Yes, you can use both modifier 24 and 25 together sometimes, Part B reps note. GI practi... Read more
Reader Question:
Determine Which Definitive Dx Applies to Suspected Crohn's
Question: The gastroenterologist conducted a colonoscopy to determine whether a patient ha... Read more
Reader Question:
Get a Handle on Comprehensive History Requirements
Question: If I have a chief complaint, an extended history of present illness (HPI), a pro... Read more
You Be the Coder:
Which Modifier Applies to This Case?
Question: Our gastroenterologist and a general surgeon performed surgery on a patient — ... Read more
E/M 2021:
3 FAQs Lead You to E/M Coding Bliss Next Year
Hint: You'll want to clock your time more accurately next year. You've got less than a ye... Read more
Telehealth Coding:
Get the Scoop on Reporting Telehealth Visits Under New Rules
Updated regulations went into effect in March. Even if your gastroenterology practice isn... Read more
Patient Privacy:
Solid Risk Analyses Can Protect Your Practice from Fines, Accusations
Find out how to avoid this gastroenterologist's fate by understanding the steps you must ... Read more
Reader Question:
Keep Track of Which EGD Codes You Can Report Together
Question: Our GI physician performed EGD with polyp ablation and also polyp removal by sna... Read more
Reader Question:
Get a Handle on Observation Care Codes
Question: Which code set should we use when the gastroenterologist admits a patient to obs... Read more
Reader Question:
Don't Look Too Far for 911 Code
Question: An established patient presented to our practice thinking he was having severe h... Read more
You Be the Coder:
Which Code Applies for PEG Tube Removal?
Question: One of our gastroenterologists removed a PEG tube during an office visit but did... Read more
Part B Quiz:
Test Your Skills With These Colorectal Screening Scenarios
Colonoscopies aren't the only types of colorectal screenings. Your gastroenterologist pro... Read more
Medicare Advantage:
6 Facts Get You up to Speed on Medicare Advantage Plans
Hint: Coverage rules may vary quite a bit from Part B guidelines. If it feels like you're... Read more
Postoperative Coding:
Polish Your Modifier 78 Claims With 3 Quick Tips
Don't confuse 78 with similar modifiers. Although every GI physician strives to perform... Read more
Reader Question:
Evaluate G-tube Replacement Options
Question: We just saw a patient who had a worn out G-tube. The gastroenterologist removed ... Read more
Reader Question:
Records Transfer is Typically Free
Question: Our practice discharged a patient due to non-payment, and one week later a new g... Read more
You Be the Coder:
Get Clarity on Modifier 24
Question: I read your article last month regarding modifier audits with great interest. In... Read more
CPT® 2021:
E/M Changes: Will GI Practices Benefit From Next Year's E/M Changes?
Prep for the elimination of 99201, effective Jan. 1. Most gastroenterology practices repo... Read more
Compliance:
Could Modifier Audits Sink Your Practice's Claims Accuracy Rate?
Modifiers are among auditors' hot spots, experts say. When it comes to performing self-au... Read more
How Does Your GI Coding Compare to the National Averages?
Comparing your code utilization to that of other GI practices can be easier if you have na... Read more
Reader Question:
New PCM Codes Apply to 1 Physician, CMS Says
Question: There are multiple gastroenterologists at our practice. Can the physician who's ... Read more
Reader Question:
Don't Let Noncovered Diagnoses Trip up Your Coding
Question: Does Medicare restrict coverage to only the diagnoses listed under the code's Lo... Read more
You Be the Coder:
How Do We Differentiate Ligation from Excision?
Question: Our GI physician typically documents hemorrhoid “ligations,” but this week w... Read more
Endoscopy Coding:
Could Your Separate-Day Endoscopies Put You at Risk of Audit?
Examine the outcomes from this comparative billing report for the scoop. Gastroenterologi... Read more
E/M Coding:
Examine These GI Practice Errors to Stay off CMS' Hit List
Gastroenterologists billed $116 million in improper payments last year, report says. If y... Read more
HIPAA:
Is Your Practice Protected Against Security Breaches?
Ensure you're taking “reasonable and appropriate” measures to avoid accusations. From... Read more
Reader Question:
Look to Dilator Type When Selecting Dilation Code
Question: Which CPT® code applies in this situation: “Scope passed up to middle es... Read more
Reader Question:
Count “No Charge” Visits Toward 3-Year New Patient Status
Question: Our gastroenterologist saw a patient during a quick assessment last year at no c... Read more
Reader Question:
Take Steps Before Seeing SNF Patients
Question: We saw a patient last month to treat her for colitis and we didn't realize she w... Read more
Reader Question:
No Need to Use Separate Diagnosis Codes for Modifier 25
Question: We know that most insurers say separate diagnoses are not required to use modifi... Read more
You Be the Coder:
Payer Rules Dictate Fecal Bacteriotherapy Codes
Question: Our gastroenterologist used fecal bacteriotherapy as a treatment for a clostridi... Read more
Medical Practice Tips:
10 Tips Help Every GI Practice Work More Efficiently This Year
Make a formal error-checking process to keep your practice moving smoothly. You know each... Read more
GI Nurse Visit Coding:
Get Down to the Details for Nurse Visits
Tip: Yes, you do need thorough documentation when reporting 99211. Your nurses provide vi... Read more
Telehealth:
MAC Reps Shed Light on Appropriate Telehealth Reporting
Tip: In most cases, you can't bill these services from patients' homes. If you're hoping ... Read more
Reader Question:
How Would You Code This Upper Endoscopy?
Question: We performed an upper endoscopy of the stomach, esophagus, and duodenum with bio... Read more
Reader Question:
Know How to Use Modifier 62
Question: Recently, our gastroenterologist performed an esopha­gogastroduodenoscopy ... Read more
You Be the Coder:
Are E/M Changes on the Horizon?
Question: We have heard conflicting reports about whether big changes are coming to E/M pa... Read more
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