2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing (On-Demand)

Video Transcription

Video Summary

In the video, the speaker answers several questions related to coding and billing for colonoscopies. The first question asks about using the PT modifier for Medicare if a screening colonoscopy turns into a therapeutic colonoscopy. The speaker confirms that the PT modifier can be used in this situation, but the patient is still responsible for the 20% that Medicare does not pay. The second question asks if a patient can be eligible for screening benefits despite a positive history or symptom if the provider indicates in the office note that it does not require an endoscopic exam. The speaker says that if the symptom does not require endoscopic evaluation, then the indication would still be screening and the patient qualifies for screening benefits. The next question is about using the modifier 53 for an aborted colonoscopy due to poor prep. The speaker says that the colonoscopy code with the modifier 53 would be used and the diagnosis code for poor prep would also be used. However, further information may be requested and the note would need to be submitted for review. The rest of the questions discuss various coding and billing scenarios for different procedures and conditions. The speaker provides explanations and recommendations based on payer policies and guidelines. No credits were mentioned in the video.

Keywords

coding

billing

colonoscopies

PT modifier

Medicare

screening benefits