2023 Gastroenterology Reimbursement and Coding Update (Virtual)

Pdf Summary

The document provides a preview and discusses current issues impacting GI practice in 2023. It is presented by Kathleen A Mueller, President of AskMueller Consulting, LLC. The document includes a disclaimer stating that the information provided was accurate at the time of the course and that updates are changing regularly due to the ongoing health emergency. The presenter discloses a financial relationship with Boston Scientific.<br /><br />The document covers various topics including the extension of the Public Health Emergency (PHE), changes to the 2023 ASC (Ambulatory Surgery Center) Fee Schedule, changes to the 2023 Physician Fee Schedule, updates on CMS Screening Colonoscopy, new 2023 CPT codes, updates to the 2023 ICD-10-CM codes, an update on ACA coverage for follow-up colonoscopy after positive stool-based screening findings, and payer updates from Horizon BC/BS and Cigna.<br /><br />Some highlights include the extension of the PHE, a 3.8% increase in the 2023 ASC fee schedule, a decrease in the conversion factor for the 2023 Physician Fee Schedule, updates to Evaluation and Management (E/M) visit coding guidelines, expansion of Medicare coverage for colorectal cancer screening, and changes to reimbursement policies for E/M codes appended with Modifier 25 by Horizon BC/BS.<br /><br />The document also mentions additional topics to be discussed, such as ICD-10 and HCC/Risk Adjustment, screening versus diagnostic procedures, medical necessity, pathology and ancillary services, anesthesia services, and other top issues impacting GI practices.<br /><br />The information provided in the document is subject to interpretation by insurance carriers and may not be considered legal or accounting advice. It is recommended to consult with a professional for specific coding requirements and guidelines for reimbursement.

Asset Subtitle

Kathleen A. Mueller, RN, CPC, QMC, QGMC, CCS-P, ICD-10 Proficient

Keywords

GI practice

2023

Kathleen A Mueller

AskMueller Consulting

PHE extension

ASC fee schedule increase

Physician Fee Schedule conversion factor

E/M visit coding guidelines

Medicare coverage

colorectal cancer screening