Billing for gastroenterology is not general billing with a different code set. Screening versus diagnostic distinction on the same procedure, which changes both the code and the patient’s cost share.
Preventive coverage rules make the screening/diagnostic line the single most consequential coding decision in the specialty.
At a glance
What drives the coding
Screening versus diagnostic distinction on the same procedure, which changes both the code and the patient’s cost share.
What drives the payer behavior
Preventive coverage rules make the screening/diagnostic line the single most consequential coding decision in the specialty.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where gastroenterology claims actually fail
- Screening converted to diagnostic without the right modifier
- Patient billed cost-sharing on a preventive service
- Anesthesia billed separately without support
How we work it
We code from what your record documents and query you when it does not support a code, which in gastroenterology is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We keep the books. You run the business.
Categorization, reconciliation, month-end close, and clean financial statements — with nothing left for you to chase.
View pricingHow It Works
Review
We look at your current gastroenterology denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Gastroenterology — Frequently Asked Questions
Do you have coders who know gastroenterology?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — screening versus diagnostic distinction on the same procedure, which changes both the code and the patient’s cost share.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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