Best Practices for Correct Coding and Billing of GI Procedures

Here are best practices for updating gastroenteorlogy coding and billing from Stephanie Ellis, RN, CPC, president of Ellis Medical Consulting.

Approximately 25 percent of the 2014 CPT code changes affect the field of GI, according to the American Medical Association. The additions below cover esophagoscopy, esophagogastroduodenoscopy, endoscopic retrograde cholangiopancreatography and image-guided fluid collection drainage by catheter.

•    Codes 43191-43918
•    Codes 43211-43214
•    Code 43229
•    Code 43233
•    Codes 43253-43254
•    Code 43266
•    Codes 43270
•    Codes 43274-43278
•    Codes 49405-49407

"Code 4327, which can be used for the ablation in Barrett's esophagus cases, is a good addition," says Ms. Ellis. "Medicare pays $550 for it."


Previously reimbursed only in hospitals, there are two significant additions to the ASC Medicare list:

•    Code 60240: Thyroidectomy with an average Medicare payment of $2,160
•    Code 60500: Parathyroidectomy with an average Medicare payment of $1,938

"ASCs only can perform these codes on healthy Medicare beneficiaries, because Medicare doesn’t pay for overnight stays" says Ms. Ellis. Patient selection is very important.

CPT codes are copyrighted by the AMA.


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