Gastroenterology Coding Alert
CPT® Coding:
End the Enema Coding Enigma With This FAQ
Plus, get a can't-miss quick tip about cost. Enemas are a bit confusing for coders, and f... Read more
End the Enema Coding Enigma With This FAQ
Plus, get a can't-miss quick tip about cost. Enemas are a bit confusing for coders, and f... Read more
Modifiers:
Hurdle These Commonly Misused Modifier Challenges
And pick up some documentation tips along the way. As you know, modifiers are useful b... Read more
Hurdle These Commonly Misused Modifier Challenges
And pick up some documentation tips along the way. As you know, modifiers are useful b... Read more
Compliance:
Properly Handle PHI to Remain HIPAA Compliant
Beware how easy it is to accidentally violate privacy laws. As technology continues to ad... Read more
Properly Handle PHI to Remain HIPAA Compliant
Beware how easy it is to accidentally violate privacy laws. As technology continues to ad... Read more
Reader Questions:
Turn to This Code for Blood Clot Removal
Question: Our gastroenterologist performed an upper GI endoscopy (EGD) on a patient w... Read more
Turn to This Code for Blood Clot Removal
Question: Our gastroenterologist performed an upper GI endoscopy (EGD) on a patient w... Read more
Reader Questions:
Review Table 2 to Renew Data Counting Confidence
Question: If a lab test is ordered and the review of results must be combined with ot... Read more
Review Table 2 to Renew Data Counting Confidence
Question: If a lab test is ordered and the review of results must be combined with ot... Read more
Reader Questions:
Turn to E/M for This G-Tube Procedure
Question: How is the removal of a patient's gastrostomy tube (G-tube) in an office se... Read more
Turn to E/M for This G-Tube Procedure
Question: How is the removal of a patient's gastrostomy tube (G-tube) in an office se... Read more
You Be the Coder:
Focus on the Scope for This Dilation Coding Question
Question: Our gastroenterologist had difficulty passing the dilators during an upper ... Read more
Focus on the Scope for This Dilation Coding Question
Question: Our gastroenterologist had difficulty passing the dilators during an upper ... Read more
Procedure Coding:
Overcome Common ERCP Coding Confusion with These Expert Tips
And learn which modifiers to use with different procedures. Even though you're dealing wi... Read more
Overcome Common ERCP Coding Confusion with These Expert Tips
And learn which modifiers to use with different procedures. Even though you're dealing wi... Read more
E/M Coding:
Dominate Data Counting with This MDM Advice
Look for additional advice on when not to count data. As you learned from Gastroenterology... Read more
Dominate Data Counting with This MDM Advice
Look for additional advice on when not to count data. As you learned from Gastroenterology... Read more
Practice Management:
Practice These Tips to Become a Pro Payer Contract Negotiator
Hint: Persistence is crucial. As we sprint toward 2023, now might be time to run some dia... Read more
Practice These Tips to Become a Pro Payer Contract Negotiator
Hint: Persistence is crucial. As we sprint toward 2023, now might be time to run some dia... Read more
Reader Question:
Avoid Prepopulating Encounter Notes
Question: One of our interns sometimes helps out as a scribe. I have noticed that he somet... Read more
Avoid Prepopulating Encounter Notes
Question: One of our interns sometimes helps out as a scribe. I have noticed that he somet... Read more
Reader Question:
Be Privy to Incident-To Rules
Question: A new patient came in and the nurse practitioner (NP) took the initial history a... Read more
Be Privy to Incident-To Rules
Question: A new patient came in and the nurse practitioner (NP) took the initial history a... Read more
Reader Question:
Stick to Intended Procedure in This 'Quick Look' Scenario
Question: The physician took a quick look past the duodenum during an EGD. Do I instead co... Read more
Stick to Intended Procedure in This 'Quick Look' Scenario
Question: The physician took a quick look past the duodenum during an EGD. Do I instead co... Read more
You Be the Coder:
Understand Ulcer Coding With This Scenario
Question: Our gastroenterologist saw a 66-year-old patient who complained of severe stomac... Read more
Understand Ulcer Coding With This Scenario
Question: Our gastroenterologist saw a 66-year-old patient who complained of severe stomac... Read more
News You Can Use:
Review the Revamped Office/Outpatient Consultation Codes, Part 2
Get the scoop on consult reimbursement. Last month, Gastroenterology Coding Alert outline... Read more
Review the Revamped Office/Outpatient Consultation Codes, Part 2
Get the scoop on consult reimbursement. Last month, Gastroenterology Coding Alert outline... Read more
CPT® Coding:
Still Puzzled By These 2022 Endoscopic Procedure Codes? Here’s Help
Check out expert tips on how to scour the documentation. Ten months after their integrati... Read more
Still Puzzled By These 2022 Endoscopic Procedure Codes? Here’s Help
Check out expert tips on how to scour the documentation. Ten months after their integrati... Read more
E/M Coding:
Follow This Advice to Correctly Code for Time
Compare these auditor red flags with your practice's processes. Determining the level of ... Read more
Follow This Advice to Correctly Code for Time
Compare these auditor red flags with your practice's processes. Determining the level of ... Read more
Reader Questions:
Know When to Report Signs and Symptoms
Question: Our gastroenterologist referred a patient to a radiologist for an abdominal... Read more
Know When to Report Signs and Symptoms
Question: Our gastroenterologist referred a patient to a radiologist for an abdominal... Read more
Reader Questions:
Learn What’s Needed for Showing Necessity
Question: My provider said that as long as we include a diagnosis code for a condition, th... Read more
Learn What’s Needed for Showing Necessity
Question: My provider said that as long as we include a diagnosis code for a condition, th... Read more
Reader Questions:
Know Who Needs to Provide Documentation
Question: My provider looked to another provider for their opinion on one of our patient's... Read more
Know Who Needs to Provide Documentation
Question: My provider looked to another provider for their opinion on one of our patient's... Read more
You Be the Coder:
Understand What to Do With Ruled-out Diagnoses
Question: The gastroenterologist suspected Barrett's esophagus, which prompted an upper GI... Read more
Understand What to Do With Ruled-out Diagnoses
Question: The gastroenterologist suspected Barrett's esophagus, which prompted an upper GI... Read more
News You Can Use:
Review the Revamped Office/Outpatient Consultations Codes, Part 1
Get a grip on updated descriptions and expert advice on using MDM versus time. January 1... Read more
Review the Revamped Office/Outpatient Consultations Codes, Part 1
Get a grip on updated descriptions and expert advice on using MDM versus time. January 1... Read more
Condition Spotlight:
Defer To This Advice When Coding Diverticulosis/itis
Hint: Watch for bleeding and perforation. There are almost two dozen codes to choose fr... Read more
Defer To This Advice When Coding Diverticulosis/itis
Hint: Watch for bleeding and perforation. There are almost two dozen codes to choose fr... Read more
ICD-10 Coding:
Code Constipation with Confidence
Walk through the sample encounters and see if you agree with our experts. There's no ques... Read more
Code Constipation with Confidence
Walk through the sample encounters and see if you agree with our experts. There's no ques... Read more
Reader Questions:
Know the Difference Between Celiac and Gluten Sensitivity Codes
Question: Can I code gluten sensitivity using K90.0? Pennsylvania Subscriber Answ... Read more
Know the Difference Between Celiac and Gluten Sensitivity Codes
Question: Can I code gluten sensitivity using K90.0? Pennsylvania Subscriber Answ... Read more
Reader Questions:
Consider Age When Coding Pediatric Stomach Pain
Question: Is pediatric stomach pain coded differently than adult stomach pain? I've ... Read more
Consider Age When Coding Pediatric Stomach Pain
Question: Is pediatric stomach pain coded differently than adult stomach pain? I've ... Read more
Reader Questions:
Refer to New Cat III Code for FMT Procedures
Question: I'm not sure how to code a fecal microbiota transplant (FMT). We don't do m... Read more
Refer to New Cat III Code for FMT Procedures
Question: I'm not sure how to code a fecal microbiota transplant (FMT). We don't do m... Read more
You Be the Coder:
Uncover the Correct Code for This Vague Ulcer Scenario
Question: A patient presents with sharp stomach pain. The gastroenterologist performs... Read more
Uncover the Correct Code for This Vague Ulcer Scenario
Question: A patient presents with sharp stomach pain. The gastroenterologist performs... Read more
News You Can Use:
Learn When to Use New Long Term Drug Therapy Codes
Hint: Some will affect medical decision making (MDM). There are almost 1,500 ICD-10-CM ch... Read more
Learn When to Use New Long Term Drug Therapy Codes
Hint: Some will affect medical decision making (MDM). There are almost 1,500 ICD-10-CM ch... Read more
Coding Quiz:
Take This Quiz to Test Your Tube Coding Talent
Learn to spot the differences between the procedures. You've probably coded several encou... Read more
Take This Quiz to Test Your Tube Coding Talent
Learn to spot the differences between the procedures. You've probably coded several encou... Read more
ICD-10 Revisions:
Look Ahead to New SDoH and Noncompliance Codes for 2023
And get a glimpse of these clarifying guideline changes. Starting Oct. 1, 2022, you'll h... Read more
Look Ahead to New SDoH and Noncompliance Codes for 2023
And get a glimpse of these clarifying guideline changes. Starting Oct. 1, 2022, you'll h... Read more
Coding Quiz Answers:
Check Your Answers to Our Tube Coding Quiz
See how well you can identify the correct CPT® codes. Now that you have tried your han... Read more
Check Your Answers to Our Tube Coding Quiz
See how well you can identify the correct CPT® codes. Now that you have tried your han... Read more
Reader Questions:
Get Specific When Coding Polyp Removal
Question: I'm trying to select the most accurate diagnosis code for a polyp removal, ... Read more
Get Specific When Coding Polyp Removal
Question: I'm trying to select the most accurate diagnosis code for a polyp removal, ... Read more
Reader Questions:
Support These Clip Codes With Plenty of Notes
Question: My gastroenterologist used a clip to mark endoscopic tissue. I don't see a ... Read more
Support These Clip Codes With Plenty of Notes
Question: My gastroenterologist used a clip to mark endoscopic tissue. I don't see a ... Read more
Reader Questions:
Know the Differences Among These Endoscopy Codes
Question: Our gastroenterologist examined a patient's esophagus, stomach, and duoden... Read more
Know the Differences Among These Endoscopy Codes
Question: Our gastroenterologist examined a patient's esophagus, stomach, and duoden... Read more
You Be the Coder:
Brush Up on Your Hernia Repair Coding
Question: CPT® requires modifier 50 or a laterality modifier for epigastric hernias ... Read more
Brush Up on Your Hernia Repair Coding
Question: CPT® requires modifier 50 or a laterality modifier for epigastric hernias ... Read more
ICD-10 Coding:
Test Your Hernia Coding Prowess With These 3 Scenarios
Can you find the right diagnosis codes for these different types of hernias? Gastroentero... Read more
Test Your Hernia Coding Prowess With These 3 Scenarios
Can you find the right diagnosis codes for these different types of hernias? Gastroentero... Read more
E/M Coding:
Know Which Code Is Which When Deciding on Prolonged Services
Hint: The difference between the two codes comes down to one word. When 2021 arrived, so ... Read more
Know Which Code Is Which When Deciding on Prolonged Services
Hint: The difference between the two codes comes down to one word. When 2021 arrived, so ... Read more
Part B Coding:
Correct Common Medicare Part B Billing Errors
And use the handy clip & save table for quick links to National Government Services (N... Read more
Correct Common Medicare Part B Billing Errors
And use the handy clip & save table for quick links to National Government Services (N... Read more
Reader Questions:
Understand When to Query for More Information
Question: My provider saw a patient suffering from nausea, vomiting, and epigastric ... Read more
Understand When to Query for More Information
Question: My provider saw a patient suffering from nausea, vomiting, and epigastric ... Read more
Reader Questions:
Find that Findings Don’t Always Turn a Screening Diagnostic
Question: A patient had a routine colonoscopy screening done. I coded the screening a... Read more
Find that Findings Don’t Always Turn a Screening Diagnostic
Question: A patient had a routine colonoscopy screening done. I coded the screening a... Read more
Reader Questions:
Take Control Over Your Modifier 54/55 Knowledge
Question: How do I code for a post-op service performed by a different physician? Fo... Read more
Take Control Over Your Modifier 54/55 Knowledge
Question: How do I code for a post-op service performed by a different physician? Fo... Read more
You Be the Coder:
Know When and How to Code a Procedure with an E/M
Question: My provider performed a procedure and performed an evaluation and managemen... Read more
Know When and How to Code a Procedure with an E/M
Question: My provider performed a procedure and performed an evaluation and managemen... Read more
Condition Coding:
Understand Coverage Criteria to Confidently Code Fecal Microbiota Transplants
And learn how and when to use an ABN. How to properly report fecal microbiota transplants... Read more
Understand Coverage Criteria to Confidently Code Fecal Microbiota Transplants
And learn how and when to use an ABN. How to properly report fecal microbiota transplants... Read more
E/M Coding:
Follow 5 Simple Steps, Benchmark Your Way to Precise GI Coding
Where do your gastroenterologists stand when it comes to national trends? Every GI practi... Read more
Follow 5 Simple Steps, Benchmark Your Way to Precise GI Coding
Where do your gastroenterologists stand when it comes to national trends? Every GI practi... Read more
Clip & Save:
Check This Breakdown of Which Codes Gastroenterologists Are Reporting Nationwide
Then, compare your coding trends to those of other GI providers. Once you evaluate your p... Read more
Check This Breakdown of Which Codes Gastroenterologists Are Reporting Nationwide
Then, compare your coding trends to those of other GI providers. Once you evaluate your p... Read more
Reader Questions:
Tackle This Gastrostomy Closure Coding Conundrum
Question: Is there a specific CPT® code for closure of an old G-tube site? The notes... Read more
Tackle This Gastrostomy Closure Coding Conundrum
Question: Is there a specific CPT® code for closure of an old G-tube site? The notes... Read more
Reader Questions:
Confidently Report Counseling Codes in Conjunction with E/M
Question: Can a GI specialist bill for alcohol abuse and intervention in addition to ... Read more
Confidently Report Counseling Codes in Conjunction with E/M
Question: Can a GI specialist bill for alcohol abuse and intervention in addition to ... Read more
Reader Questions:
Know When Not to Code Dilation with Esophagoscopy
Question: Is 43214 the most appropriate dilation code to pair with 43212? The doctor ... Read more
Know When Not to Code Dilation with Esophagoscopy
Question: Is 43214 the most appropriate dilation code to pair with 43212? The doctor ... Read more
You Be the Coder:
Follow This Guidance to Avoid Colonoscopy Denials
Question: A patient under the age of 45 came in for a colonoscopy due to a family his... Read more
Follow This Guidance to Avoid Colonoscopy Denials
Question: A patient under the age of 45 came in for a colonoscopy due to a family his... Read more
Pre-Colonoscopy Visits:
E/M With Screening Colonoscopy? In Some Cases, Report Both
You may have to perform a quick review of the claim to make sure. GI physicians perform c... Read more
E/M With Screening Colonoscopy? In Some Cases, Report Both
You may have to perform a quick review of the claim to make sure. GI physicians perform c... Read more
Diagnosis Coding:
Understand Which Z Codes Span Beyond Z12.11
Don't stop with colonoscopy screening Z codes, experts say. If Z12.11 (Encounter for scr... Read more
Understand Which Z Codes Span Beyond Z12.11
Don't stop with colonoscopy screening Z codes, experts say. If Z12.11 (Encounter for scr... Read more
2022 E/M Coding:
Find the Answers to Your Pressing Split/Shared E/M Visit Questions
The new rule for 2022 does apply to observation care, reps say. As most gastroenterology ... Read more
Find the Answers to Your Pressing Split/Shared E/M Visit Questions
The new rule for 2022 does apply to observation care, reps say. As most gastroenterology ... Read more
Reader Questions:
Understand Critical Care Scenario for GI Doctor
Question: Our physician met an established patient with severe gastrointestinal blee... Read more
Understand Critical Care Scenario for GI Doctor
Question: Our physician met an established patient with severe gastrointestinal blee... Read more
Reader Questions:
Understand Motility Study Coding
Question: We just got a chart for an esophageal manometry, but we don't know what it ... Read more
Understand Motility Study Coding
Question: We just got a chart for an esophageal manometry, but we don't know what it ... Read more
Reader Questions:
Staff Scheduling May Require Time Study
Question: We've been having trouble figuring out how many people to schedule. We're ... Read more
Staff Scheduling May Require Time Study
Question: We've been having trouble figuring out how many people to schedule. We're ... Read more
You Be the Coder:
Understand GERD Coding
Question: A new patient to our practice presented with a complaint of heartburn. The ... Read more
Understand GERD Coding
Question: A new patient to our practice presented with a complaint of heartburn. The ... Read more
Biopsies:
Answer These 3 Biopsy FAQs to Submit Clean Claims Every Time
Hint: Watching the NCCI edits will be critical when evaluating these scenarios. When you... Read more
Answer These 3 Biopsy FAQs to Submit Clean Claims Every Time
Hint: Watching the NCCI edits will be critical when evaluating these scenarios. When you... Read more
GI Nurse Visit Coding:
Can You Code These Nurse Visit Coding Scenarios?
Remember: The time element was removed from 99211 last year. Many coders spend time scrut... Read more
Can You Code These Nurse Visit Coding Scenarios?
Remember: The time element was removed from 99211 last year. Many coders spend time scrut... Read more
Part B Coding:
Confused About 2022 Coding and Billing Rules? Check These Quick Tips
Understand what MAC reps can (and can't) do. From reporting split/shared services to mov... Read more
Confused About 2022 Coding and Billing Rules? Check These Quick Tips
Understand what MAC reps can (and can't) do. From reporting split/shared services to mov... Read more
Reader Questions:
Check This EHR Guidance
Question: We've read several articles in Gastroenterology Coding Alert about the dan... Read more
Check This EHR Guidance
Question: We've read several articles in Gastroenterology Coding Alert about the dan... Read more
Reader Questions:
Understand Initial Hospital Care Coding
Question: Can you use inpatient initial care codes 99221-99223 more than once in the ... Read more
Understand Initial Hospital Care Coding
Question: Can you use inpatient initial care codes 99221-99223 more than once in the ... Read more
Reader Questions:
Differentiate Modifier 52 From Modifier 53
Question: I know that when billing a limited colonoscopy to Medicare I should use mod... Read more
Differentiate Modifier 52 From Modifier 53
Question: I know that when billing a limited colonoscopy to Medicare I should use mod... Read more
You Be the Coder:
Can You Pinpoint Duodenal Stent Insertion Code?
Question: Which code applies when the physician places a duodenal stent during endosc... Read more
Can You Pinpoint Duodenal Stent Insertion Code?
Question: Which code applies when the physician places a duodenal stent during endosc... Read more
Reflux Monitoring:
3 Tips Help You Differentiate Reflux Testing Codes
Remember: Time is a factor when choosing between 91037 and 91038. If your gastroenterolog... Read more
3 Tips Help You Differentiate Reflux Testing Codes
Remember: Time is a factor when choosing between 91037 and 91038. If your gastroenterolog... Read more
Privacy:
Secure Your Emails to Avoid This GI Practice’s Fate
This practice's email breach also caused practice funds to be diverted elsewhere. Technic... Read more
Secure Your Emails to Avoid This GI Practice’s Fate
This practice's email breach also caused practice funds to be diverted elsewhere. Technic... Read more
Follow 7 Quick Tips to Cut Your Fraud Risk
When you're working in a busy medical office, it can be challenging to stay on top of ever... Read more
When you're working in a busy medical office, it can be challenging to stay on top of ever... Read more
Modifiers:
Check 3 Quick Tips to Ensure You Understand the Modifier 25 Regs
Know how to quantify what's ‘separately identifiable.' Reporting a separate evaluation ... Read more
Check 3 Quick Tips to Ensure You Understand the Modifier 25 Regs
Know how to quantify what's ‘separately identifiable.' Reporting a separate evaluation ... Read more
Use This Handy Tool to Differentiate Between Modifiers 25 and 57
Your modifier 25 claims should meet all of the following criteria: The E/M occurs on th... Read more
Your modifier 25 claims should meet all of the following criteria: The E/M occurs on th... Read more
Reader Questions:
Look to 46600 for Anoscopy
Question: A patient presented with intermittent bright red blood in the stool, and the gas... Read more
Look to 46600 for Anoscopy
Question: A patient presented with intermittent bright red blood in the stool, and the gas... Read more
Reader Questions:
Understand How to Differentiate 99050 From 99051
Question: When it comes to billing after-hours or evening codes, is it true that ther... Read more
Understand How to Differentiate 99050 From 99051
Question: When it comes to billing after-hours or evening codes, is it true that ther... Read more
You Be the Coder:
Understand Enema Coding
Question: Our physician administered an enema to address an obstruction. Is 74283 the righ... Read more
Understand Enema Coding
Question: Our physician administered an enema to address an obstruction. Is 74283 the righ... Read more
Compliance:
CMS: Gastroenterologists Logged Over $146 Million in Projected Improper Payments
Colonoscopies, upper GI procedures appeared to have been error-prone last year. From colo... Read more
CMS: Gastroenterologists Logged Over $146 Million in Projected Improper Payments
Colonoscopies, upper GI procedures appeared to have been error-prone last year. From colo... Read more
Discover Which States Logged the Highest Error Rates
CMS and the Medicare Administrative Contractors (MACs) process claims from all 50 U.S. sta... Read more
CMS and the Medicare Administrative Contractors (MACs) process claims from all 50 U.S. sta... Read more
ICD-10-CM Coding:
Test Your Ulcer Diagnosis Coding Skills With This Quick Quiz
Can you select the right ICD-10 code for these scenarios? When your GI physician sees a p... Read more
Test Your Ulcer Diagnosis Coding Skills With This Quick Quiz
Can you select the right ICD-10 code for these scenarios? When your GI physician sees a p... Read more
Coding Edits:
Do the MUEs Make You Confused? 4 Key Facts Can Help
These frequency edits can cause claim denials for GI professionals. If your GI practice r... Read more
Do the MUEs Make You Confused? 4 Key Facts Can Help
These frequency edits can cause claim denials for GI professionals. If your GI practice r... Read more
Reader Questions:
Amendments Require Careful Attention
Question: One of our physicians made mistakes on several charts and printed out new docume... Read more
Amendments Require Careful Attention
Question: One of our physicians made mistakes on several charts and printed out new docume... Read more
Reader Questions:
Is This ‘New’ Patient Truly New?
Question: A GI provider in our large practice saw a patient, and the patient was bil... Read more
Is This ‘New’ Patient Truly New?
Question: A GI provider in our large practice saw a patient, and the patient was bil... Read more
You Be the Coder:
Check This Heartburn Coding Scenario
Question: We recently saw a new patient who complained of heartburn and difficulty swallow... Read more
Check This Heartburn Coding Scenario
Question: We recently saw a new patient who complained of heartburn and difficulty swallow... Read more
Part B Payments:
CMS to Phase Out Coinsurance for Colorectal Screenings That Turn Diagnostic
Plus: 2022 Final Rule also provides insight into split/shared visits. Gastroenterology pr... Read more
CMS to Phase Out Coinsurance for Colorectal Screenings That Turn Diagnostic
Plus: 2022 Final Rule also provides insight into split/shared visits. Gastroenterology pr... Read more
ICD-10-CM Coding:
4 Quick Questions Guide You to the Best Stomach Pain Code
Hint: Always pinpoint age, symptom, severity, and site. Few diagnosis codes get as much... Read more
4 Quick Questions Guide You to the Best Stomach Pain Code
Hint: Always pinpoint age, symptom, severity, and site. Few diagnosis codes get as much... Read more
Incident-To Coding:
10 Tips Help You Straighten out the Incident-To Coding Rules
You may think you understand all of the nuances about how to code incident-to services, bu... Read more
10 Tips Help You Straighten out the Incident-To Coding Rules
You may think you understand all of the nuances about how to code incident-to services, bu... Read more
Reader Questions:
Understand How Medicare Calculates Payments
Question: Does the CPT® code determine the reimbursement rate or does the ICD-10 code? I ... Read more
Understand How Medicare Calculates Payments
Question: Does the CPT® code determine the reimbursement rate or does the ICD-10 code? I ... Read more
Reader Questions:
Break Down This Procedure Note
Question: Our gastroenterologist saw a new inpatient for complaints of sudden onset severe... Read more
Break Down This Procedure Note
Question: Our gastroenterologist saw a new inpatient for complaints of sudden onset severe... Read more
You Be the Coder:
Which Code Applies to pH Monitoring Test?
Question: Our gastroenterologist saw a patient suffering from recurrent heartburn that had... Read more
Which Code Applies to pH Monitoring Test?
Question: Our gastroenterologist saw a patient suffering from recurrent heartburn that had... Read more