decisionhealth Newsletters, Part B News - 2014 Issue 12 (December)
Shift of values for 2015 new, revised codes means confusion for gastroenterology
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Article Overview
This article covers the 2015 transition in gastroenterology coding for lower GI procedures, including CMS’s interim approach for valuing new and revised services, the resulting use of different code sets for Medicare versus other payers, and the crosswalks discussed by professional organizations. It is relevant to gastroenterology practices, coders, billing staff, and facilities that need to understand which 2015 codes and Medicare-related substitutions are associated with the change.
Why This Topic Matters
The change creates a temporary split in billing workflows and affects how practices and facilities report lower GI services in 2015. Understanding the article helps coding and reimbursement teams align claims handling with payer type and the 2015 transition process.
Article Sections
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Billing
Introduces the 2015 lower GI billing transition and the emergence of different coding approaches for Medicare and other payers.
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Some confusion over payment
Discusses the payment-related uncertainty and the mismatch between physician and facility reporting during the transition year.
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Use this crosswalk to bill GI codes correctly to Medicare, payers in 2015
Presents the crosswalk tables and summarizes the coding framework used for Medicare, facilities, and non-Medicare claims in 2015.
What You Will Learn
- How the 2015 gastroenterology coding transition affected lower GI procedure reporting
- Which organizations and policy changes influenced the interim billing approach
- How crosswalk guidance was organized for Medicare, facility, and non-Medicare claims
- What types of procedures were included in the transition discussion
Who Should Read This
- Gastroenterology practices
- Medical coders
- Billing staff
- Reimbursement specialists
- Ambulatory surgical centers
- Hospital outpatient departments
Codes Discussed
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