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Why This Topic Matters

The article addresses common real-world billing situations that can affect claim accuracy, payer processing, and consistent patient classification across a group practice. It is especially relevant for GI practices and offices that need to align coding practices with current CPT and Medicare guidance.

Article Sections

1. Balloon dilation of the duodenum

   Discusses endoscopic management of a duodenal narrowing and the coding options considered for reporting the service. It focuses on whether a standard endoscopy code, an unlisted procedure code, or an add-on adjustment approach may be applicable.

2. Everything old is new again

   Explains how new and established patient status is determined in a group practice setting. It also references specialty distinctions and related guidance from CPT and Medicare.

3. Use endoscopy code for polyp removal during screening

   Addresses reporting when a screening colonoscopy becomes therapeutic because of findings during the procedure. The section covers how to think about the screening service, the procedure series, and associated diagnosis coding at a general level.