Part B Insider - 2015 Issue 8
Lower GI: Generate Clean EUS Claims With This Advice
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Article Overview
This article explains how lower GI endoscopic ultrasound claims are affected by 2015 CPT changes and related Medicare reporting considerations. It is aimed at coders, billers, and physicians working with general surgery, gastroenterology, and colorectal procedures. The discussion covers procedure classification, paired EUS/FNA reporting, CMS G code considerations for Medicare, and code-edit/bundling issues involving radiology services.
Why This Topic Matters
Lower GI EUS billing can be affected by multiple closely related code families, payer-specific reporting differences, and bundling restrictions. Understanding the article helps reduce denials and supports more accurate claim selection for endoscopic ultrasound services.
Article Sections
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Guide Your EUS Codes With New Definitions
This section discusses updated CPT distinctions affecting lower GI endoscopic ultrasound coding and the broad procedure categories involved.
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Combine Appropriate EUS and FNA Codes
This section addresses the relationship between EUS services and associated fine needle aspiration reporting, including a clinical example.
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Beware of Medicare
This section covers Medicare-specific reporting considerations for lower GI endoscopy services and the use of alternate payer reporting codes.
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Resist Reporting Radiology Codes With EUS
This section summarizes code-edit concerns involving radiology services reported alongside lower GI EUS and related procedures.
What You Will Learn
- How lower GI endoscopic ultrasound services are organized under CPT 2015 guidance
- How related EUS and fine needle aspiration topics are grouped in the article
- What Medicare-related reporting issues are discussed for lower GI endoscopy services
- Which general categories of radiology code pairing concerns are addressed
Who Should Read This
- Medical coders
- Billing specialists
- General surgeons
- Gastroenterology staff
- Colorectal surgery teams
Codes Discussed
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