2023 Gastroenterology Reimbursement and Coding Update (On-Demand) | November 2022-Proper Documentation for Advanced Endoscopy: Reimbursement Tips when Billing Unlisted Procedure Codes

Proper Documentation for Advanced Endoscopy: Reimbursement Tips when Billing Unlisted Procedure Codes

Video Transcription

Video Summary

In the video, the speaker discusses proper documentation for advanced endoscopies. They outline common advanced procedures, including endoscopic ultrasound, EMR, submucosal dissection, chromoendoscopy, optical chromoendoscopy, PoEM, TIF, ERCP, and endoscopic closure of fistulas. The speaker emphasizes the need for accurate documentation to support each procedure and to ensure proper payment. They provide examples of the information that should be included in the documentation for each procedure and discuss the relevant CPT codes and modifiers. They also discuss the importance of communication between coders and providers to ensure accurate billing. The speaker addresses the billing of unlisted procedures and advises providers to submit a cover letter or letter of medical necessity along with the operative report to explain the procedure and justify the reimbursement. They warn that claims for unlisted procedures without precise procedure descriptions may be denied by Medicare. Overall, the video provides guidance and information on the proper documentation and billing for advanced endoscopies.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

advanced endoscopies

proper documentation

CPT codes

modifiers

billing

unlisted procedures

Medicare