Gastroenterology Billing That Digs Into the Details
Between complex procedure bundling rules, ever-changing screening guidelines, and the nuances of facility vs professional billing, GI practice revenue cycles require specialized expertise. We help gastroenterologists navigate these challenges—so you can focus on patient care rather than claim denials.
Last quarter, we helped a 12-physician GI group recover $187,000 in previously denied claims by correcting modifier usage and screening documentation. But beyond the numbers, we give you back 10+ hours per week previously spent arguing with payers about polyp removal coding or anesthesia bundling.
Get Your Free Revenue AnalysisPrecision GI Procedure Coding
We handle the complexities that impact your bottom line:
Endoscopy Coding
- Screening vs diagnostic colonoscopies
- EGD with dilation (43245 vs 43248)
Therapeutic Procedures
- Polyp removal documentation
- ERCP coding (43260-43278)
Coding Tip: For screening colonoscopies that become diagnostic, we ensure:
✓ PT modifier applied ✓ Detailed polyp findings ✓ Family history documentation ✓ Surveillance interval recommendations
Modifier Mastery for GI Billing
We apply modifiers with precision to maximize reimbursement:
Common GI Modifiers
- 33 (Preventive service)
- 59 (Distinct procedural service)
Screening Modifiers
- PT (Colorectal screening)
- KX (Medical necessity)
Bundling Rules
- 51 (Multiple procedures)
- 76 (Repeat procedure)
Pro Tip: We maintain a database of payer-specific modifier requirements updated quarterly.
Facility & Anesthesia Revenue Optimization
We maximize reimbursement for ASCs and office-based endoscopy:
Facility Fees
Coding for GI-specific supplies
Anesthesia
Time units documentation
Pathology
Specimen handling codes
Our Facility Billing Process:
- Verify procedure-specific facility fees
- Document anesthesia start/stop times
- Track pathology specimens
- Reconcile supply costs
Preventive Care & Eligibility Management
We prevent denials before they happen:
Screening Criteria
- Age-based eligibility
- Family history documentation
Benefit Verification
- Preventive vs diagnostic coverage
- Patient responsibility estimates
Our Prevention Advantage:
✓ 92% first-pass approval for screening colonoscopies ✓ $0 patient surprise bills ✓ Real-time eligibility checks
"Their GI billing specialists increased our ASC collections by 35% by properly coding facility fees and anesthesia time. They caught that we were undercoding our ERCPs—that correction alone added $68,000 annually. Now I spend my time in the procedure room, not fighting with payers about modifier 59."
Dr. Raj Patel
Digestive Health Specialists
Ready to Streamline Your GI Billing?
Get a free analysis of your last 90 days of claims. We'll identify your top opportunities to:
- Reduce endoscopy denials
- Optimize modifier usage
- Maximize facility revenue