ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Onboarding (Day One)

Pdf Summary

This document outlines billing and coding updates in the field of gastroenterology, providing crucial insights for healthcare professionals, particularly those involved in medical billing and coding. The document underlines the importance of coding accuracy for proper reimbursement and effective healthcare management.<br /><br />Key updates discussed include an overview of the revenue cycle, differentiating between ICD-10CM, CPT, and HCPCS codes, and revisiting evaluation and management (E/M) coding guidelines. A significant focus is made on rational coding specificity to better represent clinical scenarios and improve healthcare data accuracy, which is essential for disease management and public transparency.<br /><br />The document highlights crucial diagnosis and procedural coding principles using ICD-10 and CPT codes. It emphasizes the need for coding diseases to the highest specificity, such as the introduction of new ICD-10CM codes in 2025 for digestive diseases and metabolic conditions, including BMI ranges and obesity classes.<br /><br />The document further explores key coding elements, including medical decision-making, which is discussed as a critical factor in determining service levels and supporting medical necessity. Billing codes like G2211 and G0136 are introduced to address complexities within patient management, including social determinants of health (SDOH).<br /><br />Moreover, service levels based on medical decision-making complexity are detailed, along with new CPT codes for telemedicine that cater to both audio and video consultations, which are becoming more prevalent in medical practice.<br /><br />The document emphasizes the need for comprehensive documentation to facilitate accurate billing and reimbursement, highlighting the role of detailed medical records in capturing patients' clinical narratives. It also underscores the necessity for practices to adapt to new coding standards through regular audits and peer reviews.<br /><br />Overall, the paper provides a detailed guide for medical professionals on recent updates and methodologies in coding and billing, ensuring compliance, efficiency, and enhanced patient care management.

Asset Subtitle

Jill Olmstead, DNP, ANP-BC, FAANP

Keywords

gastroenterology

medical billing

coding accuracy

ICD-10CM

CPT codes

HCPCS codes

E/M coding

telemedicine

medical decision-making

revenue cycle