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

13_Billing_Coding - Olmstead

Pdf Summary

This document provides an overview of billing and coding in healthcare, specifically in the context of gastroenterology. The document explores the most common follow-up office code billed in gastroenterology and discusses the components of a patient's note that determine the level of service. It also delves into the different coding systems, such as the AMA/CPT and HCPCS codes, and highlights the importance of coding specificity in accurately representing the care provided and capturing accurate data.<br /><br />The document further explains the revenue cycle and how coding systems translate services performed and expected payment. It mentions specific codes related to gastroenterology, such as those for colonoscopy and colorectal cancer screening. It also introduces ICD-10CM codes and provides an overview of the tabular list of codes in different chapters.<br /><br />The document emphasizes the need to code to the highest specificity, especially in conditions such as irritable bowel syndrome. It discusses the principles of diagnosis coding and provides examples of different codes relating to various medical conditions.<br /><br />Additionally, the document delves into the evaluation and management codes for new and established patient visits, as well as consultation codes. It explains the factors that determine the level of work, including history, physical examination, and medical decision-making.<br /><br />The document also highlights the key changes in coding guidelines, including the definition of time and the inclusion of social determinants of health codes. It provides coding elements for key documentation, such as chief complaint, treatment/plan of care, and ancillary tests.<br /><br />Finally, the document discusses payor options, including government payors and private sector payors, and emphasizes the importance of medical decision-making and evidence-based medicine in coding.<br /><br />Overall, this document provides a comprehensive overview of billing and coding in healthcare, specifically in the context of gastroenterology, covering various coding systems, guidelines, and considerations.

Keywords

billing and coding

gastroenterology

coding systems

revenue cycle

ICD-10CM codes

irritable bowel syndrome

evaluation and management codes

coding guidelines

payor options

medical decision-making