Gastroenterology Billing Services
One modifier decides whether a colonoscopy costs your patient nothing or hundreds. We get it right.
Why Gastroenterology Billing Needs a Specialist Team
GI billing turns on distinctions most billers handle badly: a screening colonoscopy that becomes diagnostic mid-procedure, multiple endoscopy payment rules when biopsies and polypectomies stack, sedation billed separately or bundled by payer, and parallel professional and facility claims for ASC cases.
Our GI team applies the screening-to-diagnostic modifier logic that protects patients' preventive benefits (and your online reviews), sequences multi-procedure endoscopy claims for correct payment, and manages ASC facility billing alongside professional fees.
The Challenges We Solve
Screening vs. Diagnostic Logic
PT and 33 modifiers applied correctly when screenings find polyps — preserving zero-cost-share benefits.
Multiple Endoscopy Rules
Same-session procedures ranked and reduced per payer methodology so stacked claims pay correctly.
Sedation Billing
Moderate sedation billed separately where payers allow, bundled where they don't — per plan, not by habit.
ASC & Facility Claims
Professional and facility sides billed in sync, with device and supply capture on the facility claim.
Frequently Asked Questions
Usually a modifier failure: when a screening finds a polyp, correct modifier use keeps preventive cost-sharing protections intact under most plans. Miscoded claims process as diagnostic and shift costs to the patient — the most common GI billing complaint, and preventable.
Yes — professional claims and ASC facility claims are managed together, keeping dates, codes and modifiers aligned so neither side triggers a mismatch denial.