Common Gastroenterology Billing CPT Codes to Know

Gastroenterology relies on procedural coding for motility studies, imaging, and endoscopic exams. Accurate CPT coding is important for gastroenterology clinics to support clinical documents as payer needs continue to evolve. There are several CPT codes which include upper GI endoscopy CPT codes to advanced esophageal function testing codes inside the GI billing process.


It becomes a difficult process for the healthcare staff to take care of their patients along with streamlining all the administrative hassles. This is where most clinics take the help of a reputed gastroenterology billing company in that matter who has dedicated experts knowing all the complex nuances of the claim submission procedure.



Which are the Gastroenterology Billing Codes Most Clinics Use?


Each of these codes can significantly make or break the clinic’s revenue cycle if not understood correctly. So, understanding each and every code is highly important.


Upper GI Endoscopy CPT Codes


The first five codes are upper GI endoscopy CPT codes. Diagnostic EGD is denoted by CPT code 43235 which is commonly used for GERD evaluation and upper abdominal pain. The code 43239 is used for EGD with biopsy which is used for H. pylori testing and Barrett’s surveillance. Moreover, 43251 code is used for EGD with snare lesion removal, which is useful for gastric polyps and duodenal adenomas.


Colonoscopy CPT Codes


The colonoscopy CPT codes comes into effect in which 45378 code is used for diagnostic colonoscopy, and 45380 code is used for colonoscopy with biopsy. In addition to that, 45385 code is used for colonoscopy with snare polypectomy and 45390 is used for colonoscopy with EMR. Finally, 45381 code is used for colonoscopy with submucosal injection which is used to improve lesion visualization.


Advanced Gastroenterology Billing Imaging and Capsule Endoscopy


Then the codes for advanced GI imaging and capsule endoscopy come. Here, the CPT code 91110 is used for small bowel capsule endoscopy which is used for obscure GI bleeding and unexplained iron deficiency amenia. Then 91113 code comes for capsule endoscopy for colon which is used for patients who are unable to undergo all the traditional colonoscopy because of sedation risk, refusal or incomplete procedure.


Advanced Esophageal Function Testing


Finally, the advanced esophageal function testing code comes in which 91037 code is used for esophageal function study with electrode. It is basically used for detailed esophageal motility disorder evaluation, including effective esophageal motility and pre-surgical assessment for achalasia procedures. Then the extended esophageal function testing code 91038 comes which is used for complex evaluation of motility disorder when prolonged monitoring is needed.


As there are so many codes, it becomes difficult for the in-house staff to tackle all these coding nuances, and that is where the need for a third-party service comes in handy.


How Do Outsourced Gastroenterology Billing Services Help?


These offshore experts can reduce your operational costs by 80% and can provide 10% buffer resources to make sure no issue occurs. They also provide dedicated account managers and the best infrastructure setup according to the client’s needs. These gastroenterology billing companies have no binding contract or restrictive clause and have less than two days of turnaround time in case any issue occurs.

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