ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Onboarding (Day One) | March 2023-Questions and Answers: Session 4

Video Transcription

Video Summary

In this video, Jill, a coding and billing expert, answers various questions related to coding in the medical field. She clarifies that coding to the highest specificity for certain conditions like IBS does not result in greater reimbursement under Medicare Advantage plans. She also explains that different specialties have specific codes and taxonomy codes for billing purposes. Jill discusses the possibility of coding and billing for lengthy phone calls, indicating that there are specific codes available but whether insurance companies will reimburse for them is uncertain. She also mentions that reimbursement for telehealth and telephone visits may change once the public health emergency ends. Additionally, she addresses concerns about undercoding and overcoding, emphasizing that both are considered coding fraud. Finally, she discusses the requirements for billing new patient visits and consultations, as well as the legal considerations for PAs working as sole providers in New York State. The video also includes some additional discussions on billing modifiers and the publication of adenoma detection rates (ADR) in high-quality colonoscopy practices.

Keywords

coding

billing

Medicare Advantage plans

telehealth

undercoding