Gastroenterology Billing Services
RevClinic360 provides specialized gastroenterology billing services built for the high-volume, procedure-heavy workflow of GI practices. Our certified coders are experts in colonoscopy and EGD coding, endoscopic intervention billing, hepatology services, inflammatory bowel disease management, and the complex interplay between screening, diagnostic, and therapeutic procedure classifications that significantly impact patient cost-sharing and practice reimbursement.
Gastroenterology billing is heavily procedure-based and requires meticulous attention to coding rules that differentiate screening from diagnostic colonoscopies, properly capture endoscopic interventions (polypectomy, biopsy, dilation, stent placement), and correctly apply modifier rules for multiple procedures performed during a single session. The distinction between a screening colonoscopy converted to diagnostic — and how that affects patient cost-sharing under ACA rules — is a common source of confusion that our team navigates expertly. We also handle complex hepatology billing including liver biopsy, FibroScan, and hepatitis treatment management.
- Colonoscopy coding with proper screening vs. diagnostic vs. therapeutic classification and ACA cost-sharing rules.
- EGD and advanced endoscopic procedure billing including polypectomy, biopsy, dilation, and stent placement.
- Hepatology service coding for liver biopsies, FibroScan, hepatitis management, and transplant evaluations.
Our GI billing team prevents common revenue losses such as miscoding screening colonoscopies that convert to diagnostic, failing to capture multiple polypectomy techniques separately, and missing charges for pathology interpretation of biopsy specimens. We also manage infusion billing for biologic therapies used in inflammatory bowel disease, ensure proper facility vs. ASC vs. office-based coding, and handle the authorization requirements for advanced endoscopic procedures.
Frequently Asked Questions
We carefully classify each colonoscopy based on the indication and findings. A screening colonoscopy that converts to diagnostic (due to polyp removal) requires specific modifier usage to protect patient cost-sharing under ACA guidelines. We ensure proper coding to comply with federal requirements.
Yes. When multiple procedures are performed during a single endoscopic session (e.g., biopsy and polypectomy during colonoscopy), we code each technique separately with appropriate modifiers, maximizing reimbursement while following NCCI bundling rules.
We handle billing for biologic infusions (Remicade, Entyvio, Stelara) including drug coding (J-codes), administration codes, waste documentation, and the authorization and step-therapy requirements that payers impose for these high-cost medications.
Absolutely. We code appropriately for the setting of service — office, ambulatory surgery center (ASC), or hospital outpatient — applying correct facility fees, professional fees, and modifier combinations for each environment.
We specialize in hepatology billing including liver biopsy coding, FibroScan/elastography billing, hepatitis treatment monitoring, cirrhosis management, and transplant evaluation services. We ensure proper diagnosis coding to support medical necessity for all hepatology services.