Did you know that billing for a colonoscopy requires noting advancement beyond the splenic flexure? Otherwise, documentation will only support a sigmoidoscopy:
Accurate medical billing and coding for gastroenterology is challenging and requires a high level of knowledge to ensure maximum reimbursement. These challenges include billing for colorectal cancer screenings vs. colonoscopies, motility and GI function studies, documenting proper levels of evaluation and management services, category III codes for treatment of GERD and applying the use of modifiers -51, -59 and -26.
In addition, gastroenterology billing and endoscopy billing requires the ability to effectively track underpayments. This requirement often exceeds the capabilities of generic billing software and practice billing staff. GI practices not effectively targeting underpayments typically see 7%-10% lower levels of reimbursement.