2025 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2024-14 - The Other E and M We Do But Commonly Forget to Bill

14 - The Other E and M We Do But Commonly Forget to Bill

Pdf Summary

The document addresses crucial aspects of Evaluation and Management (E&M) coding in the gastroenterology (GI) field, focusing on services that are often overlooked in billing yet have the potential to enhance revenue for GI practices. The report underscores the persistent financial cuts in the GI sector, highlighting that practice fees have seen a steady decrease over the past five years, with further reductions anticipated unless legislative intervention occurs.<br /><br />Dr. Glenn Littenberg and his colleagues aim to shed light on various E&M services that are frequently underutilized or not billed for, which could mitigate some financial pressures on GI practices. These services include transitional care management, remote patient monitoring, telehealth, chronic care management, and online digital E/M services.<br /><br />The document stresses the importance of utilizing the right coding practices for these services post-COVID-19, detailing Medicare rules and the appropriate codes to use. For instance, it explains coding for telephone and online digital services, virtual check-ins, and eConsultations, which allow health care providers to communicate efficiently with patients and other providers.<br /><br />The authors encourage GI practices to capitalize on other potential revenue streams such as processing fees for open-access colonoscopy patients, supplement sales, nutrition services, and obesity management. The paper also outlines the evolving landscape of telehealth services and the potential for payment parity with traditional in-person services.<br /><br />To aid practices, resources for more in-depth guidance on coding, such as the ASGE Coding Primer and the Medicare Physician Fee Schedule Look-Up, are provided. The overarching message is that by embracing and correctly billing for a broader array of services, GI practices can improve their financial footing amidst ongoing reimbursement challenges.

Keywords

Evaluation and Management

E&M coding

gastroenterology

billing

revenue enhancement

transitional care management

telehealth services

Medicare coding

GI practices

financial challenges