2024 Gastroenterology Reimbursement and Coding Update | November 2023-05 - Proper Documentation for Advanced Endoscopy

05 - Proper Documentation for Advanced Endoscopy_Mueller

Pdf Summary

This document provides an overview of proper documentation and billing for advanced endoscopic procedures. The presenter, Kathleen A Mueller, RN, CPC, CCS-P, QMGC, QMC, ICD-10 Proficient, discusses various procedures such as endoscopic ultrasound (EUS), endoscopic mucosal resection (EMR), endoscopic submucosal dissection, pancreatic necrosectomy, EUS with fiducial marker placement, endoscopic gastrocutaneous fistula closure, EDGE (endoscopic ultrasound directed transgastric ERCP), peroral endoscopic myotomy (POEM), G-POEM, transoral incisionless fundoplication (TIF), and optical endomicroscopy.<br /><br />The document provides specific billing guidelines for each procedure, including the use of CPT codes and modifiers. It emphasizes the importance of accurate documentation and claims processing to avoid claim denials. The document also provides detailed examples of procedure descriptions, endoscopic findings, and pathology diagnoses for each procedure.<br /><br />For procedures that do not have specific CPT codes, such as endoscopic pancreatic necrosectomy, the document advises using unlisted procedure codes and submitting a separate report that describes the procedure in plain and simple language. The document also emphasizes the importance of creating cover letters and providing relevant documentation to support the medical necessity of the procedures.<br /><br />Overall, the document aims to provide guidance on proper documentation and billing practices for advanced endoscopic procedures, helping healthcare providers ensure accurate reimbursement and claims processing.

Keywords

documentation

billing

endoscopic procedures

endoscopic ultrasound

endoscopic mucosal resection

pancreatic necrosectomy

EUS with fiducial marker placement

endoscopic gastrocutaneous fistula closure

peroral endoscopic myotomy

transoral incisionless fundoplication