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Gastroenterology Coding Alert

CPT®:
Don’t Cut Off Your Endoclip Coding Knowledge
Understand when to use an unlisted-procedure code. GI physicians use endoclips to control... Read more
Year in Review Quiz:
Can You Recall 2023’s Coding Updates? Take this Year-in-Review Quiz
Answer these questions to help you hit the ground running in 2024. As the door closes on... Read more
Practice Management:
Set Up a Solid CDI Process with These Strategies
See the benefits of regular self-audits. Even though effective clinical documentation i... Read more
Year in Review Quiz:
Check Your Answers to Our 2023 Year-in-Review Quiz
Find out if your coding comprehension is up to date. Once you've answered the quiz questi... Read more
Reader Question:
Remind Your Provider About Same-Day Record Writing
Question: My provider didn't have time to write all the notes in a patient's medical ... Read more
Reader Question:
Remember the Reason for the Encounter in this GERD Case
Question: The gastroenterologist saw a patient with a history of gastro­esophageal r... Read more
Reader Question:
Access the latest ABN Form and Instructions for Use
Question: I'm new to this gastroenterology practice, and I recently noticed that the... Read more
You Be the Coder:
Apply This Appendectomy Coding Advice
Question: Our surgeon began a laparoscopic appendectomy for a patient with signs of a... Read more
CPT® Coding:
Sort Through Separate Procedure Coding With These Tips
Know when and when not to append modifier 59. GI procedure codes are notorious for being ... Read more
ICD-10 Coding:
Cleanly Navigate Liver Condition Coding With This Guidance
Also: gain insight into documentation requirements. While your gastroenterology practice ... Read more
Practice Management:
Get Ready for 2024 by Strengthening Your Telehealth Program
Use this clip-and-save chart to help you select correct codes every time. As we all now ... Read more
You Be The Coder:
Ensure Proper Reimbursement in This Poor Prep Situation
Question: The patient didn't prep properly, and therefore the gastroenterologist coul... Read more
Reader Question:
Up Your Understanding of Botox in this Upper GI Scenario
Question: Our gastroenterologist injected botulinum toxin for achalasia during an upp... Read more
Colonoscopy Coding:
Master the Many Nuances of Colonoscopy Coding
Plus: learn the subtle difference between “diagnostic” and “therapeutic.” Colonos... Read more
E/M Coding:
Review 2023 E/M Changes, Look Ahead to 2024
Also: decipher a discrepancy between CPT® and CMS. As you'll recall, CPT® overhauled th... Read more
Practice Management:
Think Twice Before Billing Encounters Under Another Physician’s Credentials
Hint: Situations where you can legally use another physician's information must meet spec... Read more
Know it When You See It:
Legally Billing Services Under a Different Provider
Brush up on incident-to, Locum Tenems, and reciprocal billing. The Centers for Medicare &... Read more
Reader Questions:
Stick to the Documentation in This Stomach Pain Scenario
Question: Our provider tends to use the terms “epigastric pain” and “heartburn... Read more
Reader Questions:
Make Sure Provider Clearly Identifies Major Versus Minor
Question: Does a physician need to specifically document or use the terms “major su... Read more
Reader Questions:
Leave MDM Risk Assignment to the Provider
Question: Do inherent risks, such as perforation, make all surgeries “high risk” ... Read more
You Be the Coder:
Get Your Head Straight About Corkscrew Esophagus
Question: My provider performed an esophagogastroduodenoscopy (EGD) and described the... Read more
News You Can Use:
See What Could Be Coming in the 2024 MPFS
See how the CF cut compares to previous years. The 2024 Medicare Physician Fee Schedule ... Read more
Mythbuster:
Bust These Myths to End Global Period Perplexities
Check out the handy memory aid for when to use modifier 78. Global periods can cause con... Read more
Condition Spotlight:
Shed Light On Pediatric Obesity Interventions
Understand counseling criteria that justifies each code set. Addressing childhood obesity... Read more
Reader Questions:
Defer to Documentation to Determine Chronic or Acute
Question: Is there a specific time limit that distinguishes “acute” from “chron... Read more
Reader Questions:
Follow This Advice to Better Accommodate Deaf Patients
Question: Our new practice just gained our first deaf patient. Though the practice is... Read more
Reader Questions:
Turn to This Code for Reflux Test with Nasal Catheter
Question: My gastroenterologist conducted an esophageal acid reflux test using a dis... Read more
You Be the Coder:
Remember Dentate Denotes Internal/External Differentiation
Question: Our surgeon excised a column of hemorrhoids that began above the dentate li... Read more
News You Can Use:
Look Ahead to ICD-10’s New Gastro Codes
Check out which codes you currently report are turning into parent codes. Starting Oct. 1... Read more
Imaging:
Learn How to Better Navigate These GI Imaging Codes
Hint: Accurate coding lies in the specific area visualized. Endoscopic ultrasound (EUS) s... Read more
Artificial Intelligence:
Exercise Caution When Using AI in Recruitment Process
Be careful to not violate ADA, Title VII protections. Artificial intelligence (AI) is u... Read more
Reader Questions:
Consider the Reason for the Refill in This Rx Encounter
Question: How do I bill for an established patient coming in for a medication refill? AAP... Read more
Reader Questions:
Turn to 00813 for These Same-Encounter Procedures
Question: When coding anesthesia for a screening colonoscopy and esophagogastroduodenoscop... Read more
Reader Questions:
Remember that Insertion and Replacement Tube Codes Differ
Question: Could you please clarify how to code for percutaneous insertion of tubes, such a... Read more
You Be the Coder:
Can You Code This Gastroenteritis Case?
Can You Code This Gastroenteritis Case? Question: Recently a mother came in with her 4-ye... Read more
Modifiers:
Reject the Impulse to Use 59 on Every Separate Service
Learn when other modifiers might be more appropriate. Through the years, modifier 59 (Dis... Read more
Documentation:
Communication is Key for Better Documentation
Here's a helpful acronym to take back to your provider. Documentation was a hot topic a... Read more
Quiz:
Get Solid Documentation Advice With the Answers to This Quiz
Learn the different criteria for CPT®, MDM, and SDoH reporting. As “Communication is K... Read more
Reader Questions:
Peek at Payer Policy Before Reporting This Stent Procedure
Question: The physician exchanged two stents in the common bile duct. Do I report one... Read more
Reader Questions:
Examine Your Understanding of “Sample” Versus “Biopsy”
Question: When my provider collects samples during esophagogastroduodenoscopy (EGD), ... Read more
Reader Questions:
See Why CCM with CPO Is a No-Go
Question: One of our patients had been recently discharged from the hospital due to a... Read more
You Be the Coder:
See If This Sigmoidoscopy Case Leaves You Stumped
Question: A patient who underwent a total colectomy and retained a rectal stump came ... Read more
Colonoscopy Coding:
Avoid Four Errors for Correct Colonoscopy Coding
And check out these commonly misunderstood modifiers. From differentiating between screen... Read more
CPO Coding:
Keep Documentation Airtight When Reporting CPO Services
Hint: Don't forget to append modifier GV. Gastroenterologists commonly perform home heal... Read more
Practice Management:
CMS Increases Oversight and Relaxes Admin Burden with MA Updates
Here's what healthcare professionals are saying about the changes. As gastroenterology c... Read more
Reader Questions:
Check Out This CCM Caveat
Question: I know that typically the physician establishes a care plan in chronic care... Read more
Reader Questions:
Be Aware of the Cause of Bleeding When Reporting EGDs
Question: The medical record states that the gastroenterologist performed an esophago... Read more
Reader Questions:
Understand Uncertain Diagnoses When Determining MDM
Question: Does an undiagnosed new problem with uncertain diagnosis automatically tra... Read more
You Be the Coder:
Report the EGD and Consultation in This Referral Scenario
Question: Our gastroenterologist recently saw a new patient who was referred by their... Read more
CPT® Coding:
Get the Scoop on Reporting New Hernia Repair Codes
Find out what your provider needs to document for reimbursement. As you probably know, se... Read more
Colonoscopy Coding:
Gain Insight on 2023 Coding Updates for CRC Screening Coverage
And see what is still up for debate. In Gastroenterology Coding Alert Volume 25, Number 1... Read more
Practice Management:
Prioritize Accuracy to Avoid Undercoding Trouble
Get helpful tips on how to avoid accidental coding abuse. Even the best-intentioned and ... Read more
Reader Questions:
Go General in This Abdominal Pain Encounter
Question: A 31-year-old patient saw our gastroenterologist complaining of abdominal pain l... Read more
Reader Questions:
Resist Reporting the E/M in This EGD Scenario
Question: I billed Medicare for an EGD and a hospital inpatient visit using the 57 modifie... Read more
Reader Questions:
Review the Differences Between Rejection and Denial
Question: One of the claims I submitted was recently rejected, and I can't find anything w... Read more
You Be the Coder:
Find Out Whether to Code an EMR or Straight-Up Snare
Question: I have a doctor who does endoscopic mucosal resection (EMR) for large polyps. He... Read more
Procedure Coding:
Examine the Differences Between Esophagoscopy and EGD
Hint: It comes down to location and work performed. Knowing which upper GI procedure code... Read more
Virtual Visits:
Find Out What to Expect for Digital E/M Codes Post-PHE
Plus, review the codes and the documentation required. In the January issue of Gastroent... Read more
Practice Management:
Challenge Claim Denials With These 5 Tips
And look for practice patterns to help avoid denials in the first place. Appealing denia... Read more
Reader Questions:
Understand the Importance of POS for Push Enteroscopy
Question: The gastroenterologist performed a push enteroscopy and she's wondering if... Read more
Reader Questions:
Supply Specifics to Support Modifier 22 Claims
Question: The gastroenterologist performed a colonoscopy but spent an hour navigatin... Read more
Reader Questions:
Stick to Signs and Symptoms in This Situation
Question: Our gastroenterologist had an initial consult with a new patient who suffer... Read more
You Be the Coder:
Home in on These Hot Biopsy Codes
Question: Our provider performed a hot biopsy for a polypectomy. I've never heard of ... Read more
Condition Spotlight:
Check Out This Celiac Coding Insight
Learn to determine whether the chronic condition is stable. As a gastroenterology coder, ... Read more
Practice Management:
Follow These Steps to Smooth Transition Tensions When the PHE Ends in May
Use the next two months to undo two years of flexibilities. With the COVID-19 public hea... Read more
Mythbusters:
Bust These Myths to Move Your Motility Coding in the Right Direction
Gain some incident-to insight as well. Gastroesophageal reflux disease (GERD) is somethin... Read more
Reader Questions:
Tour the Table for MUE Override Guidance
Question: Our gastroenterologist performed a medically necessary procedure and provi... Read more
Reader Questions:
Opt to Not Report This Corrected Congenital Condition
Question: One of our providers recently saw a teenaged patient who was complaining of... Read more
Reader Questions:
Know How to Code for Normal Diagnostic Findings
Question: Our gastroenterologist referred a patient to a radiologist for an abdomina... Read more
You Be the Coder:
Up Your Ulcer Coding Game With This Scenario
Question: Soon after treating a mass with gastrojejunostomy, the gastroenterologist s... Read more
Coding Quiz:
Test Your Colonoscopy Coding Prowess With This Quiz
See if you've got what it takes to confidently command these questions. Colonoscopies rem... Read more
Documentation:
Learn to Spot Sub-Par Notes and Query With Confidence
Review the acronym M.E.A.T to help you identify documentation holes. As you know, a compl... Read more
Compliance:
Strengthen Your Audit Program With These Tips
Hint: Establishing your ‘why' and ‘how' will help you use your resources effectively. ... Read more
Reader Questions:
Take the Provider’s Words Over the Patient’s in This Symptoms Scenario
Question: A patient recently came in complaining of abdominal pain. During the examin... Read more
Reader Questions:
Refresh Your Understanding of Sigmoidoscopy Codes
Question: For one of our Medicare patients, our gastroenterologist performed a sigmoi... Read more
You Be the Coder:
Go Beyond 43232 When Biopsy Goes Beyond the Esophagus
Question: Our gastroenterologist used an endoscope with ultrasound to do a fine needl... Read more
News You Can Use:
Finalize Your Understanding of Key 2023 MPFS Rulings
See the reason why CMS changed its mind on split/shared visits. The Centers for Medicare ... Read more
Final Rule:
See and Hear These PHE Telehealth Takeaways for 2023
Get helpful reminders on how to stay HIPAA compliant. The COVID-19 public health emergenc... Read more
E/M Coding:
Master These Best Practices for Subsequent Hospital Care Coding
And check out these red flags and how to avoid them. Although most coders expect occasion... Read more
Reader Question:
Separately Report the E/M Code in These Screening Situations
Question: One of our patients presented for a screening colonoscopy, but during the v... Read more
Reader Question:
Let Provider Be Decider in This Ulcer Encounter
Question: One of our patients recently presented with an ulcer they've only experienc... Read more
Reader Question:
Probe the Payer Policy in This Potentially High-Risk Scenario
Question: We have a patient who is not due for a screening colonoscopy for another fo... Read more
You Be the Coder:
Let Descriptor Language Be Your Guide for These Codes
Question: My gastroenterologist did an impedance test to examine a patient's esophageal fu... Read more
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