Colonoscopy Billing: Payer Guidelines Matter - 2021 New Updates

1 CEU APPROVED

Format: On-Demand Webinar
Presenter: Jennifer McNamara, CPC,CPC-I,CRC,CGSC,COPC,AAPC Approved Instructor
Duration: 60 minutes

We will review the common billing errors made when billing for Colonoscopy procedures. We will discuss the Payer Guidelines for Commercial vs CMS Guidelines and proper Modifier Usage. Many payers require a specific order of Diagnosis code sequencing and misinterpreting these guidelines can lead to costly denials.

We will review several examples as well of therapeutic colonoscopy vs diagnostic. How do you interpret which modifier to use for which payer when a Colonoscopy becomes surgical when a Screening was intended? Does the code change according to the depth of the scope?

We will need to discuss proper understanding of the anatomical structure of the Large Intestine and the official CPT guidelines in order to properly code these procedures. We hope this presentation will help increase your revenue and decrease your denials in Colonoscopy Billing and Coding

Learning Objectives:

1. Learn how to avoid Costly Billing Denials
2. Learn to Interpret which modifiers to apply
3. Identify the proper anatomical structures
4. Coding Guidelines for CMS
5. Coding Guidelines for CPT
6. Proper ICD10-CM Sequencing
7. Documentation Requirements

Areas Covered in the Session:

1. Screening vs Therapeutic Colonoscopy
2. Coding by Approach and Depth: 
   - Proctosigmoidoscopy (45300-45327)
   - Sigmoidoscopy (45330-45350)
   - Colonoscopy (45378-45398)
3. Coding for Technique:
   - Hot Biopsy
   - Cold Biopsy
   - Snare
4. Coding CMS HCPCS G0121-G0105 for Screening
5. Screening Criteria by Payer
6. Proper use of Modifiers PT,33,52,53
7. ICD10-CM Coverage Guidelines per payer and proper sequencing

Suggested Attendees:

1. Office Managers
2. Hospital Administrators
3. ASC Directors
4. Coders
5. Billers
6. Physicians
7. Mid Level Providers
8. Coding and Billing Trainee

About the Presenter:

Jennifer McNamara, CPC,CPC-I,CRC,CGSC,COPC,AAPC Approved Instructor, has been working since last 18 years in many specialized areas of Coding. Currently she does remote coding for multiple surgical specialties including Orthopedics, General Surgery, Gastroenterology, Trauma. She have experience coding Urology, and Interventional Radiology. Jen is the owner of Ozark Coding Alliance LLC where she offer Education Services for Training Current and Future Coder. Offering Online Education for CPC and CRC Exam Preparation in addition to many Specialty Exams. We hold Workshops and Webinars to help you succeed in the Industry.


System Requirement

Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly


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