2026 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2025-Top 10 2025 Coding Questions/Issues received by ASGE

Video Transcription

Video Summary

This video summarizes the top 10 coding questions for 2025 received by ASGE, covering common concerns in billing and documentation. Key points include: no specific size requirement for EMRs, but detailed lesion documentation is needed; infusion services require the supervising physician’s direct presence in the same office suite for billing legitimacy; unlisted procedure codes should be compared to similar existing ones for fee schedules; pathology billing dates vary by payer but CMS directs billing at interpretation date; colonoscopy age limit is up to 85, individualized based on health; conscious sedation can be billed only under specific conditions distinct from MAC; surveillance colonoscopy coding depends on the physician's clinical judgment, not coders; Medicare limits pathology billing units and requires justification for excess; modifier use in endoscopy and colonoscopy must align with Medicare guidelines to avoid denials; and diagnostic colonoscopies, even with poor prep, have no frequency restrictions and full coverage depends on payer.

Asset Subtitle

Kathleen A. Mueller, RN, CPC, CGCS, CCS-P, CMSCS, PCS, CCC

Keywords

ASGE coding questions 2025

billing and documentation

EMR lesion documentation

infusion service billing requirements

colonoscopy coding guidelines