Gastroenterology Coding Alert
Modifier 78 Helps With Complications
Question: Can we gain reimbursement if our gastroenterologist performs a flexible sigmoidoscopy with control of bleeding to remove rubber bands within the global period of a rubber-band ligation, or is this bundled?
North Carolina Subscriber
Answer: You may report the sigmoidoscopy separately using 45334 (Sigmoidoscopy, flexible ; with control of bleeding [e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator]).
You should append modifier 78 (Return to the operating room for a related procedure during the postoperative period) to 45334 to indicate that the gastroenterologist performed the second procedure because of a complication related to the initial rubber-band ligation (46221, Hemorrhoidectomy, by simple ligature [e.g., rubber band]).
Modifier 78 requires that the physician return the patient to the OR, which--under Medicare's definition--can include an endoscopy suite.
Note that for Medicare payers, any complications of the initial surgery that the physician can handle without a return to the operating room are included in the global period of the initial procedure.
Gastroenterology Coding Alert
- Gastros Gain a Code for Enteryx, but You'll Face New Challenges
Recall means you won't likely access 0133T
CPT 2006 adds 0133T to describe implant injections to [...] - Fill the E/M Gap With Rest Home Service Codes
You'll need 3 of 3 key components to choose a service level for new patients
You [...] - CPT Update in Brief:
Now's the Time to Update Your Consult Coding
Access modifier 32 for mandated services
The deletion of follow-up inpatient (99261-99263) and confirmatory (99271-99275) consultations [...] - You Be the Coder:
Does Argon Plasma Call for a Special Code?
Question: Our gastroenterologist performed an EGD with Argon plasma coagulation for control of bleeding. What's [...] - CPT Clarifies Conscious Sedation Billing
Look to Appendix G for a complete list of services that include CS
Physician offices have [...] - Get to Know Your New Conscious Sedation Codes
Be sure to document medication and dose when reporting CS
Revisions in CPT 2006 mean you [...] - Medicare Still Won't Pay for CS
In years past, Medicare considered conscious sedation procedures 99141-99142 bundled services in all cases, and [...] - Reimbursement 'Heads-up!':
Medicare Cuts Conversion Factor 4.4 Percent for 2006
You can expect your payments from Medicare to shrink in 2006.
CMS released its 2006 Physician [...] - READER QUESTIONS:
Call on 44385 for Pouchoscopy
Question: My gastroenterologist's documentation states that he performed a -pouchoscopy.- What is this, and how [...] - READER QUESTIONS:
Modifier 78 Helps With Complications
Question: Can we gain reimbursement if our gastroenterologist performs a flexible sigmoidoscopy with control of [...] - READER QUESTIONS:
Separate Documentation Important for Modifier 62
Question: Recently, our gastroenterologist performed an EGD during the same session in which a surgeon [...] - READER QUESTIONS:
Charge Outpatient Consult for Observation
Question: Another doctor asked my GI physician for a consult with a patient who had [...] - READER QUESTIONS:
Stick With 99218-99220 for 8 or Fewer Hours
Question: When is it appropriate to report initial observation (99218-99220) with discharge (99217) versus observation [...] - The Future Of Gastroenterology:
How To Prosper Despite Coming Changes
Presented by Joel V. Brill, MD
The following supplement to Gastroenterology Coding Alert is the transcript [...] - Correction
The December 2005 Gastroenterology Coding Alert included a typographical error on page 96 in the [...]
