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Benefits of Outsourcing Gastroenterology Billing to a External Company It can be a challenging task to maintain accuracy in gastroenterology medical billing and coding. High level of knowledge and precision is required to ensure strong financial health of a gastroenterology practice.
Similar to other specialty-specific codes, gastroenterology codes have also been subject to revisions annually. Various new CPT codes have been added in these revisions, increasing coding complexities. It has become essential for the staff to know when to add Initial Observation Care time component codes, appropriate modifiers and prolonged service codes.
Billing for motility and GI function studies, colorectal cancer screenings vs. Colonoscopies , category III codes for treatment of GERD, applying the use of modifiers -26, -51 and -59 and documenting proper levels of evaluation are also some of the challenges that pose problems in gastroenterology medical billing.
Requirements for accurate gastroenterology billing and coding:
If the billing staff is not well-trained, their inability to track underpayments can result in huge revenue losses
Gastroenterology billers should have the required training to follow-up claims and make appeals so that the practice gets paid for every service offered
Practice should be well prepared for ICD-10 implementation and HIPAA compliance
HIPAA guidelines for gastroenterology documentation should also be followed
Coders and billers should be conversant with CPT coding guidelines, CMS-1500 and UB92 claim forms and so on
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