Gastroenterology Coding Alert
Dilation Coding:
Simplify Esophageal Dilation Coding With a Few Quick Tips
You must know the extent of the scope to select the right code. If your gastroenterologis... Read more
Simplify Esophageal Dilation Coding With a Few Quick Tips
You must know the extent of the scope to select the right code. If your gastroenterologis... Read more
Tube Coding:
Differentiate Tube Placement, Replacement, and Maintenance for Proper Coding
Hint: Look for inclusion of fluoroscopic guidance before selecting a code. The use of gas... Read more
Differentiate Tube Placement, Replacement, and Maintenance for Proper Coding
Hint: Look for inclusion of fluoroscopic guidance before selecting a code. The use of gas... Read more
Reimbursement:
Correct These Billing Issues to Ring in 2022 Without Worries
Learn how to maximize your revenue before the calendar turns to 2022. As the end of 2021... Read more
Correct These Billing Issues to Ring in 2022 Without Worries
Learn how to maximize your revenue before the calendar turns to 2022. As the end of 2021... Read more
Reader Questions:
Follow These Guidelines for Free Sample Distribution
Question: In the past, gastroenterologists in our practice have frequently supplied free s... Read more
Follow These Guidelines for Free Sample Distribution
Question: In the past, gastroenterologists in our practice have frequently supplied free s... Read more
Reader Questions:
Check the Calendar for Global Period Specs
Question: The CPT® surgery guidelines state that the surgical package includes one relate... Read more
Check the Calendar for Global Period Specs
Question: The CPT® surgery guidelines state that the surgical package includes one relate... Read more
Reader Questions:
Get the Scoop on Reporting Vaccine Side Effects
Question: How do we code an adverse reaction to a COVID-19 vaccine that was noted by a phy... Read more
Get the Scoop on Reporting Vaccine Side Effects
Question: How do we code an adverse reaction to a COVID-19 vaccine that was noted by a phy... Read more
You Be the Coder:
Understand the Diagnosis Code for Preprocedural Exam
Question: A patient who was scheduled for a gall bladder surgery presented for a pre-op ev... Read more
Understand the Diagnosis Code for Preprocedural Exam
Question: A patient who was scheduled for a gall bladder surgery presented for a pre-op ev... Read more
Stomach Procedures:
Apply the Lessons From This Op Note to More Accurately Code Your EGDs
Remember to differentiate biopsy from “sample collection.” When your gastroenterologi... Read more
Apply the Lessons From This Op Note to More Accurately Code Your EGDs
Remember to differentiate biopsy from “sample collection.” When your gastroenterologi... Read more
ICD-10:
Test Your Diagnosis Coding Skills With 3 Quick Questions
Hint: Know when signs and symptoms represent your most accurate coding options. In some ... Read more
Test Your Diagnosis Coding Skills With 3 Quick Questions
Hint: Know when signs and symptoms represent your most accurate coding options. In some ... Read more
Medicare Errors:
Could Error-Prone Lab Requests Put Your GI Office Under Payer Scrutiny?
Part B payers also found issues with E/M codes, diagnostic testing. When your GI practice... Read more
Could Error-Prone Lab Requests Put Your GI Office Under Payer Scrutiny?
Part B payers also found issues with E/M codes, diagnostic testing. When your GI practice... Read more
Reader Questions:
Avoid Unlisted When More Accurate Codes Exist
Question: Our GI physician performed a liver elastography using mechanical shear wave tech... Read more
Avoid Unlisted When More Accurate Codes Exist
Question: Our GI physician performed a liver elastography using mechanical shear wave tech... Read more
Reader Questions:
Understand the Latest on 99211
Question: What are the minimum documentation requirements needed to bill 99211? What has t... Read more
Understand the Latest on 99211
Question: What are the minimum documentation requirements needed to bill 99211? What has t... Read more
Reader Questions:
Always Note Most Recent Procedure
Question: One of our physicians performed coloproctostomy with colostomy for a patient wit... Read more
Always Note Most Recent Procedure
Question: One of our physicians performed coloproctostomy with colostomy for a patient wit... Read more
You Be the Coder:
Know Whether Previous Conditions Apply to a Chart
Question: Our physician recently performed an EGD with banding of the varices. The indicat... Read more
Know Whether Previous Conditions Apply to a Chart
Question: Our physician recently performed an EGD with banding of the varices. The indicat... Read more
CPT® 2022:
Check Updates to 99211, POEM Codes Effective Jan. 1
Fortunately, the latest edition of CPT® isn't as earth-shattering as last year's. The ch... Read more
Check Updates to 99211, POEM Codes Effective Jan. 1
Fortunately, the latest edition of CPT® isn't as earth-shattering as last year's. The ch... Read more
Endoclip Coding:
Using Gastro Clips? Check 4 Tips to Code Correctly
Cut out unnecessary steps when reporting endoscopic marking clips. When the GI physician ... Read more
Using Gastro Clips? Check 4 Tips to Code Correctly
Cut out unnecessary steps when reporting endoscopic marking clips. When the GI physician ... Read more
Documentation:
You Can Pinpoint MDM Easily if You ‘Think in Ink’
Check these expert tips to tally the number and complexity of problems addressed. When ... Read more
You Can Pinpoint MDM Easily if You ‘Think in Ink’
Check these expert tips to tally the number and complexity of problems addressed. When ... Read more
You Be the Coder:
Which Modifier Addresses Discontinued Procedure?
Question: Our gastroenterologist began performing an upper GI on an inpatient in the hospi... Read more
Which Modifier Addresses Discontinued Procedure?
Question: Our gastroenterologist began performing an upper GI on an inpatient in the hospi... Read more
Reader Questions:
Understand Appeal Steps
Question: We recently reported esophagogastroduodenoscopy (EGD)/ upper endoscopy for a 17-... Read more
Understand Appeal Steps
Question: We recently reported esophagogastroduodenoscopy (EGD)/ upper endoscopy for a 17-... Read more
Reader Questions:
States May Dictate e-Signature Rules
Question: Our small practice still sees a majority of our Medicare beneficiaries via tel... Read more
States May Dictate e-Signature Rules
Question: Our small practice still sees a majority of our Medicare beneficiaries via tel... Read more
Reader Questions:
Do States Dictate Medical Record Fees?
Question: Since patients' rights to access their medical records continue to dominate the ... Read more
Do States Dictate Medical Record Fees?
Question: Since patients' rights to access their medical records continue to dominate the ... Read more
Reader Questions:
Non-Medicare Payers May Perform Audits
Question: We treat pediatric patients who require GI care, so we don't submit many Medicar... Read more
Non-Medicare Payers May Perform Audits
Question: We treat pediatric patients who require GI care, so we don't submit many Medicar... Read more
ICD-10-CM Coding:
Check New Codes for Gastric Intestinal Metaplasia, COVID-19
Plus: You'll find expanded coding options for dysphagia, immunization counseling, and more... Read more
Check New Codes for Gastric Intestinal Metaplasia, COVID-19
Plus: You'll find expanded coding options for dysphagia, immunization counseling, and more... Read more
Part B Payments:
Conversion Factor Cuts Could Impact Gastroenterologists
But telehealth pay could continue into 2023, if the proposal is finalized. Gastroentero... Read more
Conversion Factor Cuts Could Impact Gastroenterologists
But telehealth pay could continue into 2023, if the proposal is finalized. Gastroentero... Read more
Modifiers:
Beyond 25: Know the Alternative E/M Modifiers
Modifiers 57 and 24 could be essential, depending global periods. Every gastroenterology ... Read more
Beyond 25: Know the Alternative E/M Modifiers
Modifiers 57 and 24 could be essential, depending global periods. Every gastroenterology ... Read more
You Be the Coder:
Can You Differentiate Food Allergy From Intolerance?
Question: We often see patients who have allergies or intolerance regarding things like gl... Read more
Can You Differentiate Food Allergy From Intolerance?
Question: We often see patients who have allergies or intolerance regarding things like gl... Read more
Reader Questions:
Documentation Lacking? It’s OK to Query Physicians
Question: Thank you for your article last month on documentation tips. We read it and have... Read more
Documentation Lacking? It’s OK to Query Physicians
Question: Thank you for your article last month on documentation tips. We read it and have... Read more
Reader Questions:
CMS: If You Break It, You Should Fix It
Question: One of our GI physicians attempted to do a banding of esophageal varices. He cou... Read more
CMS: If You Break It, You Should Fix It
Question: One of our GI physicians attempted to do a banding of esophageal varices. He cou... Read more
Polypectomies:
A Few Quick Steps Help You Collect for Colonic Polypectomies
Hint: Know when a biopsy is part of the code descriptor. Several variables come into play... Read more
A Few Quick Steps Help You Collect for Colonic Polypectomies
Hint: Know when a biopsy is part of the code descriptor. Several variables come into play... Read more
Polyp Diagnosis Coding:
Specify Location to Pinpoint the Right Colon Polyp Diagnosis Codes
Don't be vague when seeking polyp location. When selecting a diagnosis code for a polyp... Read more
Specify Location to Pinpoint the Right Colon Polyp Diagnosis Codes
Don't be vague when seeking polyp location. When selecting a diagnosis code for a polyp... Read more
Documentation:
Cut These 5 Documentation Myths From Your Life to Submit Clean Claims
Hint: Make sure all parties supply the same information to payers. If you think each pa... Read more
Cut These 5 Documentation Myths From Your Life to Submit Clean Claims
Hint: Make sure all parties supply the same information to payers. If you think each pa... Read more
You Be the Coder:
Which Diagnosis Code Applies to Ileum Biopsy?
Question: Our GI physician performed an ileum biopsy, and the pathology report notes a dia... Read more
Which Diagnosis Code Applies to Ileum Biopsy?
Question: Our GI physician performed an ileum biopsy, and the pathology report notes a dia... Read more
Reader Questions:
Eye 91010 for Motility Study
Question: Our GI physician's documentation notes that he used a manometry nasal catheter a... Read more
Eye 91010 for Motility Study
Question: Our GI physician's documentation notes that he used a manometry nasal catheter a... Read more
Reader Questions:
Find Diagnosis in Chart, Not LCD
Question: Which diagnosis code is payable for an upper GI on a 12-year-old patient? Cali... Read more
Find Diagnosis in Chart, Not LCD
Question: Which diagnosis code is payable for an upper GI on a 12-year-old patient? Cali... Read more
ICD-10 Coding:
3 Scenarios Help You Code Liver Diagnoses
Can you find the right diagnosis code for these liver conditions? From cirrhosis to hepat... Read more
3 Scenarios Help You Code Liver Diagnoses
Can you find the right diagnosis code for these liver conditions? From cirrhosis to hepat... Read more
HIPAA:
Want to Steer Clear of a Privacy Breach? Check These Key Insights
Hint: HIPAA violation fines don't appear to be slowing down. Ever wonder whether the gove... Read more
Want to Steer Clear of a Privacy Breach? Check These Key Insights
Hint: HIPAA violation fines don't appear to be slowing down. Ever wonder whether the gove... Read more
Incident-To Coding:
Check 5 Key Tips for Incident-To Coding Bliss
You'll collect 15 percent more if you bill your APP's services this way. When reporting s... Read more
Check 5 Key Tips for Incident-To Coding Bliss
You'll collect 15 percent more if you bill your APP's services this way. When reporting s... Read more
You Be the Coder:
Can You Select the Right Code Sequence?
Question: A primary care physician referred a patient with severe heartburn to one o... Read more
Can You Select the Right Code Sequence?
Question: A primary care physician referred a patient with severe heartburn to one o... Read more
Reader Questions:
You Can’t Always Report ED Codes
Question: Thanks for your article last month on inpatient coding. I have a follow-up quest... Read more
You Can’t Always Report ED Codes
Question: Thanks for your article last month on inpatient coding. I have a follow-up quest... Read more
Reader Questions:
Understand Gastric Adenoma Coding
Question: What is gastric adenoma, and how should I code it? Maine Subscriber Answer:... Read more
Understand Gastric Adenoma Coding
Question: What is gastric adenoma, and how should I code it? Maine Subscriber Answer:... Read more
Coding Quiz:
Master Your Upper GI Coding Skills With This Quick Quiz
Determine where the scope went to pinpoint the right code. Most gastroenterologists perfo... Read more
Master Your Upper GI Coding Skills With This Quick Quiz
Determine where the scope went to pinpoint the right code. Most gastroenterologists perfo... Read more
Inpatient E/M Coding:
5 Quick Tips Help You Report Inpatient Consults
Hint: Confirm inpatient status before reporting the hospital E/M codes. Picture this: An... Read more
5 Quick Tips Help You Report Inpatient Consults
Hint: Confirm inpatient status before reporting the hospital E/M codes. Picture this: An... Read more
Clip And Save:
Check This List to Perfect Your Place of Service Coding
Choosing the correct place of service (POS) code for your claims is essential to avoiding ... Read more
Check This List to Perfect Your Place of Service Coding
Choosing the correct place of service (POS) code for your claims is essential to avoiding ... Read more
You Be the Coder:
Check NCCI Bundles for Lesion Removals
Question: Our GI physician identified a 10 mm semi sessile polyp in the ascending colon, a... Read more
Check NCCI Bundles for Lesion Removals
Question: Our GI physician identified a 10 mm semi sessile polyp in the ascending colon, a... Read more
Reader Questions:
Check Sequencing Rules When Seeing HIV Patients
Question: Our gastroenterologist saw an HIV-positive patient for treatment of numerous chr... Read more
Check Sequencing Rules When Seeing HIV Patients
Question: Our gastroenterologist saw an HIV-positive patient for treatment of numerous chr... Read more
Reader Questions:
Assess PHI Risk When Calling Patient Names
Question: Is it OK to call out full names in a waiting room? Can you ask for “John Smith... Read more
Assess PHI Risk When Calling Patient Names
Question: Is it OK to call out full names in a waiting room? Can you ask for “John Smith... Read more
Reader Questions:
Inpatient E/M Services Are Billable Under Telehealth
Question: Can we report inpatient telehealth E/M services to Medicare? This has happened i... Read more
Inpatient E/M Services Are Billable Under Telehealth
Question: Can we report inpatient telehealth E/M services to Medicare? This has happened i... Read more
Reader Questions:
Discover How to Respond to Demand Letter
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
Discover How to Respond to Demand Letter
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
Diagnosis Coding:
One Quick Tip Allows You to Differentiate Crohn’s and Colitis Diagnoses
Hint: The first few characters will come down to location, location, location. Are you co... Read more
One Quick Tip Allows You to Differentiate Crohn’s and Colitis Diagnoses
Hint: The first few characters will come down to location, location, location. Are you co... Read more
Modifiers:
Modifier 22 Can Lead to Income — If You Use It Properly
Demonstrate the unique nature of the procedure, and ask for payment. Your documentation ... Read more
Modifier 22 Can Lead to Income — If You Use It Properly
Demonstrate the unique nature of the procedure, and ask for payment. Your documentation ... Read more
Documentation:
Check These Documentation Tips — Straight From Part B Reps
Don't forget to maintain medical records for 7 years. Every gastroenterology coder knows ... Read more
Check These Documentation Tips — Straight From Part B Reps
Don't forget to maintain medical records for 7 years. Every gastroenterology coder knows ... Read more
Clip And Save:
Ensure You Meet Signature Rules With These Tips
After you shore up your medical documentation, there's one last piece of the equation that... Read more
Ensure You Meet Signature Rules With These Tips
After you shore up your medical documentation, there's one last piece of the equation that... Read more
Reader Questions:
Back up Unlisted Claims With Pristine Documentation
Question: One of our physicians performed a colonoscopy on a Medicare patient with ulcerat... Read more
Back up Unlisted Claims With Pristine Documentation
Question: One of our physicians performed a colonoscopy on a Medicare patient with ulcerat... Read more
Reader Questions:
Request Medical Policies Whenever Possible
Question: I contacted my insurer and asked how they prefer me to submit codes for a partic... Read more
Request Medical Policies Whenever Possible
Question: I contacted my insurer and asked how they prefer me to submit codes for a partic... Read more
Reader Questions:
Check the Calendar Before Billing These Services
Question: The CPT® surgery guidelines state that the surgical package includes “one rel... Read more
Check the Calendar Before Billing These Services
Question: The CPT® surgery guidelines state that the surgical package includes “one rel... Read more
You Be the Coder:
Differentiate Hemorrhoid From Anus Tag
Question: A 56-year-old patient presented for a colonoscopy and also mentioned a troubleso... Read more
Differentiate Hemorrhoid From Anus Tag
Question: A 56-year-old patient presented for a colonoscopy and also mentioned a troubleso... Read more
Patient Privacy:
Avoid This GI Practices Fate — Enact Privacy Safeguards Now
A server issue is said to have prompted the breach of 2,500 patient files. Someone walkin... Read more
Avoid This GI Practices Fate — Enact Privacy Safeguards Now
A server issue is said to have prompted the breach of 2,500 patient files. Someone walkin... Read more
E/M Coding:
Can You Code These GI-Focused E/M Case Studies?
Check your E/M coding skill to ensure you've got the 2021 guidelines down pat. Now that ... Read more
Can You Code These GI-Focused E/M Case Studies?
Check your E/M coding skill to ensure you've got the 2021 guidelines down pat. Now that ... Read more
Part B Coding:
Straighten Out Your Part B Coding With 7 Essential Answers
Part B reps address several pressing questions. Do you see patients for aftercare follow... Read more
Straighten Out Your Part B Coding With 7 Essential Answers
Part B reps address several pressing questions. Do you see patients for aftercare follow... Read more
You Be the Coder:
Does This Count Toward MDM?
Question: Our gastroenterologist advised a patient to continue taking a given medication a... Read more
Does This Count Toward MDM?
Question: Our gastroenterologist advised a patient to continue taking a given medication a... Read more
Reader Questions:
Look to the Future for Colorectal Screening Coinsurance Changes
Question: Is there a change this year in how Medicare pays for colorectal cancer screening... Read more
Look to the Future for Colorectal Screening Coinsurance Changes
Question: Is there a change this year in how Medicare pays for colorectal cancer screening... Read more
Reader Questions:
Know When Z Codes Apply
Question: A patient who is scheduled for a cholecystectomy came to our office for a pre-op... Read more
Know When Z Codes Apply
Question: A patient who is scheduled for a cholecystectomy came to our office for a pre-op... Read more
Compliance:
Check These GI Practice Errors to Avoid Landing on CMS’ Hit List
Gastroenterologists billed $91M in Part B improper payments last year, report says. If yo... Read more
Check These GI Practice Errors to Avoid Landing on CMS’ Hit List
Gastroenterologists billed $91M in Part B improper payments last year, report says. If yo... Read more
Imaging:
Expect the Unexpected When Coding GI Imaging Services
Hint: Examine the specific area visualized before selecting a code. If you perform upper ... Read more
Expect the Unexpected When Coding GI Imaging Services
Hint: Examine the specific area visualized before selecting a code. If you perform upper ... Read more
Reimbursement:
Bring in More Cash This Year With 10 Quick Tips
The COVID-19 pandemic has gutted some practices financially. Nearly every gastroenterolog... Read more
Bring in More Cash This Year With 10 Quick Tips
The COVID-19 pandemic has gutted some practices financially. Nearly every gastroenterolog... Read more
You Be the Coder:
How Can You Collect for Hospice Care?
Question: Medicare recently denied a service that our GI physician provided to a patient i... Read more
How Can You Collect for Hospice Care?
Question: Medicare recently denied a service that our GI physician provided to a patient i... Read more
Reader Questions:
Consider Team Sessions When Coder/Physician Communication Is Lacking
Question: In your issue last month, you noted that if confusion exists in the medical reco... Read more
Consider Team Sessions When Coder/Physician Communication Is Lacking
Question: In your issue last month, you noted that if confusion exists in the medical reco... Read more
Reader Questions:
Method, Depth Matter for Anorectal Biopsy
Question: Our gastroenterologist performed an anorectal biopsy. Which code applies? Louis... Read more
Method, Depth Matter for Anorectal Biopsy
Question: Our gastroenterologist performed an anorectal biopsy. Which code applies? Louis... Read more
Reader Questions:
Choose MDM or Time for E/M Visits — Not Both
Question: If we're selecting an E/M level of service (99202-99215) based on medical decisi... Read more
Choose MDM or Time for E/M Visits — Not Both
Question: If we're selecting an E/M level of service (99202-99215) based on medical decisi... Read more
ICD-10 Coding:
Clarify Your GI Diagnosis Coding Know-How With These FAQs
Hint: Documentation discrepancy? Consult the gastroenterologist. As your gastroenterology... Read more
Clarify Your GI Diagnosis Coding Know-How With These FAQs
Hint: Documentation discrepancy? Consult the gastroenterologist. As your gastroenterology... Read more
E/M Coding:
Perfect Your Knowledge of the 2021 E/M Rules With 8 Quick Tips
Hint: G2212 could help you report some prolonged services. You've pored over the new E/... Read more
Perfect Your Knowledge of the 2021 E/M Rules With 8 Quick Tips
Hint: G2212 could help you report some prolonged services. You've pored over the new E/... Read more
You Be the Coder:
Check Your Options for Submucosal Injections
Question: Our gastroenterologist performed a submucosal injection during endoscopy. Which ... Read more
Check Your Options for Submucosal Injections
Question: Our gastroenterologist performed a submucosal injection during endoscopy. Which ... Read more
Reader Questions:
Look to 43238 for EGD
Question: A patient presented to our practice for suspected esophageal cancer or abnormali... Read more
Look to 43238 for EGD
Question: A patient presented to our practice for suspected esophageal cancer or abnormali... Read more
Reader Questions:
Avoid Colonoscopy Code If Colon Isn’t Addressed
Question: A patient who had a total colectomy and still had a rectal stump visited our off... Read more
Avoid Colonoscopy Code If Colon Isn’t Addressed
Question: A patient who had a total colectomy and still had a rectal stump visited our off... Read more
ICD-10 Coding:
Can You Code These Polyp Scenarios?
Hint: Your first step is to distinguish non-neoplastic from neoplastic polyps. Colon poly... Read more
Can You Code These Polyp Scenarios?
Hint: Your first step is to distinguish non-neoplastic from neoplastic polyps. Colon poly... Read more
GERD Testing:
Check These Tips When Coding Esophageal Motility Studies
Your documentation holds coding clues — you just need to know where to look. Every GI p... Read more
Check These Tips When Coding Esophageal Motility Studies
Your documentation holds coding clues — you just need to know where to look. Every GI p... Read more
E/M Coding:
Assign the Right E/M Code With This Sure-Fire Advice
The new E/M coding guidelines have arrived — make sure you're on top of them. Although ... Read more
Assign the Right E/M Code With This Sure-Fire Advice
The new E/M coding guidelines have arrived — make sure you're on top of them. Although ... Read more
You Be the Coder:
Get to Know Codes for Varices Treatment
Question: How should we code for the gastroenterologist's work treating esophageal and gas... Read more
Get to Know Codes for Varices Treatment
Question: How should we code for the gastroenterologist's work treating esophageal and gas... Read more
Reader Questions:
Consider Modifier 78 for Unplanned Return to OR
Question: We performed a colonoscopy at 9 a.m., but the patient returned to our endoscopy ... Read more
Consider Modifier 78 for Unplanned Return to OR
Question: We performed a colonoscopy at 9 a.m., but the patient returned to our endoscopy ... Read more
Reader Questions:
Know the e-Signature Rules
Question: Our practice still sees a majority of our Medicare beneficiaries via telehealth ... Read more
Know the e-Signature Rules
Question: Our practice still sees a majority of our Medicare beneficiaries via telehealth ... Read more
Reader Questions:
Look to Fee Schedule for Payment Amounts
Question: I noticed in your last issue that you shared a typical Medicare reimbursement am... Read more
Look to Fee Schedule for Payment Amounts
Question: I noticed in your last issue that you shared a typical Medicare reimbursement am... Read more