November 17, 2016
My partner mentioned that she heard all our endoscopy codes are being reduced in payment starting January 1, 2017. I don’t know if we can take one more major reduction in reimbursement. Can you clarify this??
Reimbursement changes to endoscopy codes will be effective on January 1, 2017. However, if you understand how to code these procedures under the revised 2017 coding rules, the impact on your revenues could be zero. That’s the good news. However, it will be essential to code these correctly and to establish processes in your practice to ensure you capture all revenues under the new guidelines. Very simply, the value of moderate sedation has been carved out of all endoscopy codes. However, if you perform moderate sedation, you will be able to bill for this activity under a new Medicare G code (for Medicare patients) combined with new CPT Category I codes for moderate sedation.
For more detailed information about Medicare and private payer billing under these new guidelines, please join Teri Romano for a thirty minute Zipinar on December 15, 2017, focusing on the coding and reimbursement changes for endoscopy procedures.
*This response is based on the best information available as of 11/17/16.