Inpatient Facility Coding & Compliance Alert

Here’s how to keep abreast of current terminology and accurate codes.

If your facility has an outpatient gastroenterology component, you may be interested in the changes to gastrointestinal endoscopy codes in CPT® 2015, which goes into effect Jan. 1, 2015. 

Background: The American Medical Association’s CPT®  Editorial Panel is the body that updates the code set,  weighing in the proposed changes  from the American College of Surgeons (ACS), the Society of American Gastrointestinal Surgeons (SAGES), and other such subject experts. Following this, the codes are surveyed by the specialty societies and presented to the AMA or the Relative Value Update Committee, which in turn makes recommendations to CMS. Remember, CMS is the sole owner that can decide the relative value of a procedure for providers. 

General concept: In 2015, the majority of GI endoscopy and other codes will be revised to reflect current terminology and practice. For example “with or without” is being replaced throughout by “including when performed” in an effort toward a standard language and accurate codes.

For an overview of the top GI endoscopy changes, see the chart below.