2025 Gastroenterology Reimbursement and Coding Update (Virtual)

Video Transcription

Video Summary

The video transcript discusses a Q&A session on colorectal cancer screening, focusing on scenarios involving patients under 45 with family histories of certain conditions. It highlights the complexity of determining whether procedures like colonoscopies should be classified as diagnostic or screening, emphasizing the importance of thorough documentation and understanding payer policies. The conversation also delves into the challenges of coding and billing for endoscopic procedures, such as determining the appropriate codes for techniques like underwater EMRs and navigating unlisted codes for procedures like double balloon enteroscopy. Additionally, the discussion covers the denial of certain billing codes based on place of service and how such issues might relate to diagnosis codes or incorrect billing components. The panel stresses the need for providers to be proactive in verifying eligibility and obtaining preauthorization to ensure coverage, as well as the importance of documentation to justify procedures and navigate appeals.

Keywords

colorectal cancer screening

coding and billing

underwater EMR

preauthorization

documentation