Coding in gastroenterology has changed dramatically over the past few years, with many teams now turning to electronic methods instead of manual billing practices. That said, gastroenterology coding still follows vital, complex coding guidelines that can change year-to-year, resulting in coding errors and denials.
Fundamentally, gastroenterology follows the following guidelines and coding systems:
- ICD-10-CM
- CPT
- HCPCS Level II
- Medicare National Coverage Determinations (NCDs)
- Local Coverage Determinations (LCDs)
Each year, these coding guidelines get revised and updated, ever increasing the complexity of medical coding and billing. Specifically in gastroenterology, a range of updates impact providers and care. In 2024, for ICD-10-CM codes, 395 new billable codes were introduced, these came alongside 25 deletions and 13 revisions. For CPT codes, 230 additions were created in 2024, alongside 49 deletions and 70 revisions according to AMA. There are now 11,163 codes that describe medical procedures and services, and this list continues to grow and evolve.
These coding revisions are extremely specific — for example, CPT revised office visit codes 99202-99205 and 99212-99215 to remove the time range, in minutes, from each code. As of 2024, practices must meet or exceed a ‘minimum time threshold’ (ie. met or exceeded 15 minutes, 30 minutes, 45 minutes, and so on) and this must be indicated by the unique CPT code.
Gastroenterology procedures are complex and detailed, and something as specific as the tool used, the right or left hand side of the body, or the difference between 29 minutes vs. 31 minutes spent with a doctor can cause incorrect coding and denials. As hundreds of new codes are introduced each year, it’s becoming increasingly difficult for revenue cycle teams to stay ahead of these changes.
That’s where Adonis Intelligence comes in.
Adonis Intelligence uses machine learning to alert you to coding changes and payer policy updates. This gives revenue cycle teams in gastroenterology the ability to proactively predict and prevent denials as well as address claim issues as they arise, before they become a bigger problem.
Learn how revenue cycle teams in gastroenterology are using Adonis Intelligence to keep pace with ever changing coding guidelines, mitigate denials, and increase speed-to-cash.
