2023 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2022-Questions and Answers

Video Transcription
Video Summary
In the video, the Q&A session covered various topics related to medical coding and billing. Some of the questions included: <br /><br />1. Do you need to use a modifier for G0105 (family history of colon cancer) if the patient has no polyps? The answer was no, as G codes are specifically meant for screening and do not require modifiers unless converted to a surgical endoscopy.<br /><br />2. What should be billed for a sigmoid colon abortion? The guidelines state that if the procedure cannot go beyond the splenic flexure, it should be coded as a flexible sigmoidoscopy.<br /><br />3. Is a modifier necessary when returning for another colonoscopy to remove remaining polyps? If there are still polyps present, the procedure would be considered diagnostic and no modifier is necessary.<br /><br />4. Can a brachytherapy probe placement during an EGD be billed using code 43241? The speaker suggested using this code, but noted that there is no clear definition or specific guidance on this issue.<br /><br />5. Is it appropriate to bill findings or indications first for ASC procedures? It was recommended to use findings as the primary diagnosis, unless it is a screening procedure.<br /><br />The answers given were based on the speaker's understanding and experience, and some issues may vary based on payer policies. Additional questions and answers covered topics such as demarcation for EMRs, use of modifiers 59 and XS, billing for high-grade dysplasia, and the billing of procedures using unlisted codes. The speaker also emphasized the importance of specificity in coding and the need to communicate with providers for certain diagnoses. The video did not provide any credits.
Keywords
medical coding
billing
modifiers
colonoscopy
EGD