Screening coded as diagnostic
Patient billed cost-share and the practice fields complaints. We code intent correctly with the right modifier.
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Gastroenterology medical billing services
GI billing is built on endoscopy, where screening versus diagnostic intent, modifiers and the conversion from screening to therapeutic procedure determine both payment and the patient's cost share. Office E/M, infusion and motility testing add their own layers.
What makes gastroenterology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether gastroenterology claims pay the first time.
- Screening colonoscopy (G0105, G0121, 45378 with modifier 33 or PT) versus diagnostic coding changes patient responsibility and must match the order and findings.
- When a screening becomes therapeutic (polypectomy), modifier PT for Medicare or 33 for commercial payers preserves the screening benefit.
- Multiple endoscopy rules reduce payment for additional procedures in the same session; coding order matters.
- Facility and professional claims must agree on procedure codes and modifiers or both are delayed.
Denials we see most in gastroenterology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Multiple endoscopy reductions
Unexpected reductions on same-session procedures. We sequence codes to maximize appropriate payment under the rules.
Facility and professional mismatches
Claims held because the ASC and the physician coded differently. We coordinate both sides.
How Core MB bills for gastroenterology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new gastroenterology providers runs in the same system, tracked live in your client portal.
- Screening and diagnostic coding aligned with orders and findings, with PT and 33 applied correctly.
- Multiple-procedure sequencing under payer rules.
- Coordination between professional and facility claims for ASC-based practices.
Everything in the service
The full revenue cycle as standard for gastroenterology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Gastroenterology billing questions
Why do patients get surprise bills after a screening colonoscopy?
Because the procedure was coded as diagnostic, or a polyp removal was coded without the modifier that preserves the screening benefit. Correct coding prevents the bill and the complaint.
How do multiple procedures in one session get paid?
Under multiple-endoscopy rules that reduce payment for additional procedures. Sequencing and coding matter, and we apply the rules per payer.
Do you bill for ASC facilities too?
Yes. We bill both the professional and facility sides for GI groups that own their endoscopy center, keeping the claims aligned.
How do we get started with Core MB for gastroenterology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new gastroenterology providers can start at the same time.
Find out what your gastroenterology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.