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With Everest's Gastroenterology Billing & Coding Services, you can maximize profitability and minimize errors.

Reduce denials, increase collection and fix revenue leaks

getting started with Gastroenterology Billing Services

Gastroenterology specific medical billing, coding & RCM solutions that boost profitibilty & improve patients experience.

It is essential for Gastroenterologists to be updated on various coding and billing guidelines and payer-specific protocols to run a compliant and financially successful medical practice. Billing and coding for Gastroenterology is challenging and requires an extensive amount 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 that don’t effectively target underpayments face massive revenue hemorrhage.

Hiring an in-house biller can be very expensive, and it requires a lot of time and effort. In addition, training your staff on the ever-changing regulations and guidelines of Gastroenterology billing can be very costly and time-consuming. 

One way to reduce stress on your staff and increase reimbursement is to outsource your billing & coding requirements to a technologically empowered billing company like Everest A/R Management Group Inc.

Assuring Industry's best Gastroenterology Billing Practices

At Everest, we understand the intricate details involved in GI medical billing–for example, how to bill a colonoscopy performed beyond the splenic flexure. Without this knowledge, the documentation would only support billing for a sigmoidoscopy. To avoid claim denials and maximize reimbursements, our certified coders work with you 24/7 to prevent problems stemming from incorrect use of modifiers. 

In addition, our professional billing & coding experts provide data-driven solutions that streamline Gastroenterology billing processes. This increases efficiency and decreases the amount of time needed to correctly bill services rendered, technology foundation and a team that focuses on providing data-driven solutions to ensure fewer denials and increased revenue.

Our coders are expert in Gastroenterology and are able to apply correct CPTs to avoid denials such as: 

  • CPT code 43234 (Upper GI simple examination)  replaced by CPT code 43235 (Upper GI includes esophagus, stomach, & either the duodenum and/or jejunum as appropriate; diagnostic)
  • CPT code 43206 is applied for similar purpose as CPT code 88375 (used for optical endomicroscopic imaging) but both are mutually exclusive
  • CPT code 91111 (using capsule endoscopy) revised in 2013 by CPT code 91112 (using wireless capsule endoscopy with pressure measurements)

Specialty Billing Services Florida

Our medical billing services in Florida can help you increase your revenue by reducing the number of denied and unpaid claims. Our billers in major cities like Gainesville, Jacksonville, Miami, Tampa, St. Petersburg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice.


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