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Did you know that billing for a colonoscopy requires noting advancement beyond the splenic flexure? Otherwise, documentation will only support a sigmoidoscopy.
Accurate medical billing and coding for gastroenterology is challenging and requires a high level of knowledge to ensure maximum reimbursement. These challenges include billing for colorectal cancer screenings vs. colonoscopies, motility and GI function studies, documenting proper levels of evaluation and management services, category III codes for treatment of GERD and applying the use of modifiers -51, -59 and -26.
In addition, gastroenterology billing and endoscopy billing requires the ability to effectively track underpayments. This requirement often exceeds the capabilities of generic billing software and practice billing staff. GI practices not effectively targeting underpayments typically see 7%-10% lower levels of reimbursement.
PGM is well-versed in both gastroenterology billing and endoscopy billing. From our ongoing involvement with the American Gastroenterological Association to our team of gastroenterology medical billing and coding specialists, PGM will work in conjunction with your practice to ensure you receive maximum reimbursement for services provided. PGM will identify problem areas such as the correct use of modifiers, evaluate underpayments and manage all aspects of your practice's billing.
Unreliable, inconsistent billing system
Increasing account receivable
Time-consuming follow-up with insurance companies
18% revenue increase
33% reduction in Days AR
Streamlined practice operations
Greater visibility into practice performance due to enhanced due to enhanced reporting
Patient population growth
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