Gastroenterology Billing Services

Specialty Focus

Gastroenterology Billing That Captures What You've Earned

Gastroenterology is one of the highest-revenue and highest-risk specialties for billing errors. Colonoscopy coding alone — screening vs. diagnostic distinctions, polyp removal add-ons, anesthesia coordination — can make or break a GI practice's collections without expert billing management.

Prime Medical Billing's GI billing team specialises in endoscopy and colonoscopy coding, EGD and ERCP billing, polyp removal add-on codes, and infusion therapy for Crohn's and IBD patients. We navigate the screening-to-diagnostic conversion rules, coordinate with anesthesia billing, and manage prior authorisations for high-cost biologics.

97%

First-Pass Clean Claim Rate

24h

Average Claim Submission

40%

Average A/R Reduction

Colonoscopy & endoscopy billing

Screening vs. diagnostic conversion coding

Polyp removal add-on codes (45388, 45390)

EGD & ERCP coding

GI infusion therapy (biologics)

Prior auth for GI biologics

Pathology coordination billing

High-complexity E&M coding

Electronic remittance posting

Monthly performance reporting

Specialty-Trained Coders

Our billers are trained in your specialty's CPT codes, ICD-10 diagnoses, and payer-specific rules — not generalists working across 50 specialties.

97%+ Clean Claim Rate

We scrub and submit clean claims the first time, reducing rework, accelerating payment, and improving your net collection rate.

24-Hour Denial Recovery

Every denied claim is reviewed within 24 hours, root cause identified, corrected, and re-submitted before payer appeal deadlines close.

Full HIPAA Compliance

Encrypted data handling, a signed Business Associate Agreement, and annual compliance audits — your patients' information is always protected.

Maximize Your Gastroenterology Revenue

Get a free billing audit and find out exactly how much revenue your practice could be recovering. No contracts, no obligation — just results.

Get Your Free Billing Audit Call 346-307-9057

HIPAA Compliant • No Long-Term Contracts • Results in 30 Days

How do you handle colonoscopy and polypectomy coding?

Colonoscopy billing is nuanced: a screening colonoscopy that becomes diagnostic when a polyp is found requires a specific code set (G0121 → 45378 with modifier PT for Medicare). Polypectomy techniques — biopsy, hot snare, cold snare, EMR — each have distinct CPT codes. We apply the correct code based on the operative report technique description, preventing the most common GI denial causes.

How do you coordinate anesthesia billing for GI endoscopy procedures?

When anesthesia is provided by a CRNA or anesthesiologist for GI procedures, we coordinate billing between the GI physician and the anesthesia provider. We also bill moderate sedation (99151–99153) when the GI physician provides and documents their own sedation administration.

Do you manage prior authorizations for GI procedures and diagnostics?

Yes. Many commercial payers require prior auth for colonoscopy, capsule endoscopy, upper GI series, and hepatology procedures. We submit auth requests with the clinical indication, prior treatment failures, and supporting endoscopy reports — and we track all open authorizations to prevent scheduling delays.

How do you handle ERCP and complex GI procedure billing?

ERCP (43260–43278) and other complex GI procedures involve multiple components — sphincterotomy, stent placement, stone removal — each billable when separately documented. We review operative reports line by line to ensure every documented component is captured and billed, maximizing reimbursement on high-complexity cases.

Gastroenterology Billing That Captures What You've Earned

Key Billing Areas for Gastroenterology Practices

Built for Gastroenterology Billing Complexity

Specialty-Trained Coders

97%+ Clean Claim Rate

24-Hour Denial Recovery

Full HIPAA Compliance

Maximize Your Gastroenterology Revenue

Gastroenterology Billing — FAQ

We Serve All Medical Specialties