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How to Insure Your Practice against an Avalanche of Gastroenterology Coding Challenges?

March 12, 2013

Gastroenterology codes, like other specialty-specific codes, have regularly been subject annual revisions. During the course of such revisions, many new CPT codes have been added corresponding to modifications in gastroenterology procedures while a few irrelevant codes have been taken off. As a result, physicians’ billing offices or coding staff have had to adapt themselves subtly to these inevitable changes in order to effect accurate gastroenterology coding. Even as physicians’ coding have shown admirably flexibility to imbibe these coding revisions, there is an avalanche of coding revisions waiting to unleash itself on gastroenterology practitioners – ICD-10 in itself would bring forth extensive increase in gastroenterology codes as well their specificity.

At a time when gastroenterology fee-schedules – both Medicare as well as commercial plans – continue to be rationalized further, learning and adapting successfully to these monumental coding changes is the only way to ensure your gastroenterology reimbursements are not affected.  Thus, it may warrant a greater skill and adaptability to deal with such extensive gastroenterology coding amendments. Amongst a host of mandatory coding challenges that are likely to be faced by your coding staff, the following are more important:

  • Medicare regulations
  • Basic steps to coding with ICD-9 as well as ICD-10 when ICD-10 eventually takes over ICD-9
  • Coding conventions
  • Procedure terminology
  • HIPAA guidelines for documenting and coding gastroenterology procedures
  • Being conversant with Information on handling implants
  • Being familiar with Official CPT coding guidelines
  • Being knowledgeable of key fields on both the CMS-1500 and UB-92 claim forms

Additionally, your coding staff may even be required to know when to add Initial Observation Care time component codes, prolonged services codes and appropriate modifiers to ensure that your bills stand to get reimbursed to the highest possible extent. These comprehensive coding requirements can only be managed by Certified Gastroenterology Coders with credentials such as:

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  • Ability to read and abstract physician office notes and operative notes to apply correct ICD-CM, CPT, HCPCS Level II and modifier coding assignments
  • Evaluation and management (both the 1995 and 1997 Documentation Guidelines)
  • Rules and regulations of Medicare billing including (but not limited to) incident to, teaching situations, shared visits, consultations and global surgery
  • Coding of surgical procedures performed by gastroenterologists such as colonoscopies, esophageal dilations, ERCP, etc.
  • Medical terminology, Anatomy and physiology

While you can get your coding staff trained from credible coding institution, it may require considerable training and orientation expenditure. And, there will always be a temporary impact on your Gastroenterology Billing and reimbursements whilst your coding staff is busy with orientation. To avert this possible scenario, you may well be advised to outsource the entire coding task from credible and competent agencies. And, when it comes to facilitating billing and coding services for gastroenterology practices across the 50 states in the US, Medicalbillersandcoders.com has always taken the lead in deploying the right resources; a nation-wide affiliation with certified and experienced gastroenterology coding professionals helps us to designate coders that are suitable to individualistic gastroenterology coding requirement.

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