
Elevate Gastroenterology Care with Specialized Billing Services
Expert Revenue Cycle Services for Your Digestive Health Practice
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Gastroenterology Billing & Coding Services
Gastroenterology is the branch of medicine dealing with the digestive system and its disorders. This specialty focuses on diseases affecting the gastrointestinal tract, including the organs from mouth into anus, along the alimentary canal. Physicians practicing in this field are called gastroenterologists.
To maintain a compliant and financially successful practice, gastroenterologists need to stay updated on the various coding guidelines and payer-specific protocols. Medical billing and coding for gastroenterology is challenging and requires an expert range of knowledge to ensure maximum reimbursement. These challenges include billing for colorectal cancer screenings vs. colonoscopies, motility, and GI function studies, documenting proper levels of evaluation and management services, category III codes for treatment of GERD, and applying the use of modifiers -51, -59, and -26.
Additionally, gastroenterology billing and endoscopy billing requires the ability to track underpayments effectively. This requirement often exceeds the competency of most billing software and in-house billing staff. GI practices not effectively targeting underpayments face massive revenue hemorrhage.
MBW RCM is well-versed in both gastroenterology billing and endoscopy billing. Our team of gastroenterology medical billing and coding specialists works hand-in-hand with your practice to ensure you receive maximum reimbursement for services provided. MBW will identify problem areas such as the correct use of modifiers, evaluate underpayments, and manage all aspects of your practice's billing.
MBW RCM’s Expertise in Gastroenterology
At MBW, we have a client base that spans across all 50 states, covers a wide range of hospitals, physician practices (including GI practices), and medical billing companies. We employ our experience and knowledge acquired through a decade of working with gastroenterologists in fixing & improving your revenue cycle. Our coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and are certified by the American Academy of Professional Coders (AAPC).
Applying best practices for Gastroenterology Billing & Coding Services
We understand the nuances involved in GI medical billing, such as how to bill a colonoscopy with the advancement beyond the splenic flexure. Otherwise, the documentation would be incomplete and would only support a sigmoidoscopy. Our certified coders work with you 24/7 to prevent problems caused by incorrect use of modifiers, as well as educate your in-house billing specialist on how to avoid them. Our professional billing & coding experts work to prevent claim denials while increasing the number of reimbursements. We do this by focusing on efficient, streamlined processes that decrease the amount of time needed to correctly bill orthopedic services. We have built our delivery model on a strong technology foundation and a team that focuses on providing data-driven solutions to ensure fewer denials and increased revenue.
Why MBW RCM
We bring excellence, knowledge, and accuracy to GI billing and coding services while building a revenue cycle devoid of defects for your practice.
With capabilities across the revenue cycle chain- patient demographics entry, insurance verification, insurance authorizations, coding, billing, reconciling of accounts, and denial management, we can add value to your organization through analytics-driven and result oriented processing.
Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process.
We ensure consistent accounts receivable follow-up and prior authorization to avoid claim denials. Our denial management team's #1 priority is shifting your focus from denial management to denial prevention.
Hello, World!
Gastroenterology billing involves a wide range of diagnostic and procedural services, from endoscopies to colonoscopies. Multiple procedures, modifiers, and biopsy coding can make billing more complex than general practice billing.
Common CPT codes include 45378–45398 for colonoscopy, 43235–43259 for EGD (esophagogastroduodenoscopy), and 91110–91112 for capsule endoscopy. Accuracy is key to avoid denials.
Frequent issues include missing prior authorizations, incorrect use of modifiers, inaccurate procedure coding, and insufficient documentation, especially for screening vs. diagnostic procedures.
MBW RCM ensures accurate coding, manages pre-authorizations, handles complex procedure combinations, and reduces denials through expert review and payer-specific billing knowledge.
Screening procedures are preventive and often fully covered by insurance. If a polyp or abnormality is found, the procedure may become diagnostic, requiring appropriate modifier and documentation for accurate billing.
Yes, but proper use of modifiers like -59 or -51 is critical. Each procedure must be justified as distinct and medically necessary, and supported with clear documentation.
Extremely important. Detailed procedure notes, patient history, and pathology findings are essential to support the codes billed and defend against audits or denials.
Yes, MBW RCM integrates with most EHR and endoscopy platforms to streamline documentation flow and reduce manual entry errors during coding and billing.
MBW RCM typically submits claims within 24–48 hours after receiving complete clinical documentation, ensuring fast reimbursement cycles for your gastroenterology practice.
Contact MBW RCM directly. Our pricing is customized based on your practice size, procedure volume, and specific needs. We offer transparent and scalable billing solutions.
Outsourcing to MBW RCM reduces administrative burden, improves claim accuracy, accelerates cash flow, and provides access to expert coders and denial prevention workflows. It enables your team to focus on patient care while we handle payer complexities, audits, and compliance monitoring. Our analytics help identify lost revenue opportunities and streamline reimbursements.
Benefits of Our Gastroenterology Revenue Cycle Services
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Specializing in complex gastroenterology billing cases like colorectal screenings, we ensure precise billing for optimal reimbursement.
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Our team's expertise in ICD-9/10, CPT, and HCPCS coding, certified by the AAPC, guarantees accurate and compliant coding for all gastroenterology services.
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We excel in identifying and resolving underpayments, preventing significant revenue losses and ensuring the financial health of your practice.
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Covering the entire revenue cycle, our services include patient entry, insurance verification, authorizations, and proactive denial management, streamlining your practice's operations.
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Our analytics-driven approach focuses on reducing claim denials and increasing reimbursements, enhancing your practice's financial and operational efficiency.
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Experience significant cost savings of 5-60% by leveraging our global delivery model to reduce operational expenses while maintaining high-quality billing and coding services. Unlock the catial you need for reinvestment into patient care and practice growth.
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Are you ready to streamline your revenue cycle and boost your practice's efficiency? Our specialized Gastroenterology Revenue Cycle Specialists help you streamline billing processes, increase RoI, and reduce administrative burden.