2023 Gastroenterology Reimbursement and Coding Update (On-Demand)

Pdf Summary

The document discusses several topics related to billing and coding for gastroenterology services. It starts with poll questions regarding the billing practices and complexity of visits in the field. The document then highlights the decrease in conversion factor (CF) rates over the years and the potential for conversion factor cuts to be prevented or deferred. It mentions the importance of considering "interstitial" services that are commonly forgotten or not billed for, such as transitional care services, chronic care management, and home health certification.<br /><br />The document also talks about cash services that can contribute to professional fees, including admin fees for open access patients, prep kit sales, and nutrition services. It provides examples of two types of E/M codes that are often overlooked but can generate additional revenue: telephone E/M codes and online digital E/M codes.<br /><br />The section on telephone E/M coding explains the rules and requirements for billing these services and provides a case example. The section on online digital E/M coding follows a similar format, explaining the rules and requirements and providing a case example.<br /><br />Next, the document introduces virtual check-ins and explains how they differ from telehealth services. It includes case examples and billing information for virtual check-ins.<br /><br />The document also discusses eConsultations, which are provider-to-provider consultations conducted through telephone, internet, or electronic health record platforms. It explains the rules and requirements for billing eConsultations and provides a case example.<br /><br />Finally, the document emphasizes the importance of advocating for the establishment and expansion of telehealth services beyond the COVID-19 pandemic. It mentions potential changes in telephone service coverage and the possibility of exceptions for mental health services.<br /><br />The document concludes with a list of resources for further information and invites questions from the audience.

Asset Subtitle

Glenn D. Littenberg, MD, MACP, FASGE

Keywords

billing and coding

gastroenterology services

conversion factor rates

interstitial services

telephone E/M codes

online digital E/M codes

virtual check-ins

eConsultations

telehealth services expansion

COVID-19 pandemic