2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing | November 2021-Summary of Top Coding and Reimbursement Issues Impacting Physicians and Facilities

Summary of Top Coding and Reimbursement Issues Impacting Physicians and Facilities

Video Transcription

Video Summary

In this video, the presenter discusses various coding and reimbursement issues that impact physicians and facilities. They address the top issues outlined by the Office of Inspector General (OIG) and Recovery Audit Contractors (RACs). These include billing for services not rendered, improper use of provider identification numbers, unbundling services, failure to properly use coding modifiers, upcoding the level of service provided, and more. The presenter emphasizes the importance of proper documentation, including medical record signature requirements, ICD-10 specificity, and substantiation of medical necessity. They also discuss specific issues related to multiple endoscopy billing, hemorrhoid banding, and understanding modifier 25. The presenter provides guidance and best practices to ensure compliance with payer policies and minimize denials. They stress the importance of communication and training between staff and providers.

Asset Subtitle

Kathleen A. Mueller, RN, CPC, CGCS, CCS-P, CMSCS, PCS, CCC

Keywords

coding and reimbursement issues

physicians and facilities

Office of Inspector General

Recovery Audit Contractors

billing for services not rendered