Gastroenterology Coding Alert
Put the Right ICD-9 Codes on Your GI Endoscopy Claims
Check with insurer for a complete list Note: While the listed ICD-9 codes commonly prove medical necessity on lower GI endoscopy claims, you should check with your individual carrier before using these, or any other, diagnosis codes on a claim.
Your lower gastrointestinal endoscopy claims will stand a greater chance of acceptance if you include the appropriate ICD-9 code to prove medical necessity.
Medicare carriers publish their own lists of medical-necessity codes for GI procedures on their Web sites. Insurers consider many symptoms justification for a lower GI endoscopy. Take a look at this list of often used ICD-9 codes that insurers commonly accept for lower GI endoscopy claims, courtesy of Jan Rasmussen, CPC, AGS-GI, ACS-OB, president of Professional Coding Solutions in Eau Claire, Wis.:
Example: The gastroenterologist performs a proctosigmoidoscopy on a patient with persistent diarrhea and bleeding. During the procedure, he has to control bleeding via heater probe.
On the claim, you should:
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