Mastering Colonoscopy Billing & Coding: Medicare vs. Non-Medicare

Join us for this comprehensive webinar designed for healthcare professionals managing colonoscopy claims for both Medicare and non-Medicare patients. Master the complexities of colonoscopy coding, ensure accurate billing, and optimize your reimbursements.

What You'll Learn

This intensive session covers everything you need to know about colonoscopy billing and coding, including:

Core Competencies:

• Properly differentiate between preventive and diagnostic colonoscopies
• Understand how patient risk levels impact code selection
• Navigate Medicare HCPCS codes (G0105, G0121) with CMS compliance
• Master key CPT codes for non-Medicare billing (45378, 45380, and more)
• Recognize coverage criteria differences between Medicare and private insurers

Practical Skills:

• Avoid common pitfalls leading to claim denials
• Implement best practices for thorough documentation
• Apply recent policy changes to your billing practices
• Navigate NCCI edits and Medicare's coding policy
• Use modifiers correctly (33, 52, 53, PT)

Comprehensive Curriculum

Pre-Procedure Considerations

• Evaluation and Management visits prior to screening colonoscopies
• CMS Guidelines and S0285 code usage
• High-risk vs. non-risk patient categorization
• New age requirements and USPSTF screening recommendations

Clinical Foundation

• Colon anatomy essentials for coders
• Moderate sedation: definitions, types, and requirements
• Understanding colonoscopy service types: Screening, Surveillance, Diagnostic, and Therapeutic

Coding Deep Dive

Sigmoidoscopy:

• Key coding factors
• Medicare/HCPCS codes: G0104, G0106

Colonoscopy:

• Medicare/HCPCS codes: G0105, G0120, G0121, G0122
• CPT code series: 45378, 45379-45398
• Colonoscopy decision tree framework

Compliance & Optimization

• Understanding NCCI edits and Medicare's coding policy
• Proper modifier application: 33, 52, 53, PT
• Real-world denial scenarios with examples
• Documentation requirements to support coding decisions

Learning Objectives

By the end of this webinar, you will be able to:

✓ Identify key differences between Medicare and Non-Medicare colonoscopy codes

✓ Apply current billing and coding standards for colonoscopy screenings

✓ Distinguish between diagnostic and preventive colonoscopy procedures

✓ Implement Medicare-specific rules and coding requirements for colorectal cancer screenings

✓ Accurately code for private insurers and non-Medicare payers

✓ Navigate reimbursement rates and guidelines across different payers

✓ Recognize and avoid common challenges leading to claim denials

✓ Adapt to recent policy changes impacting reimbursement rates

✓ Create proper documentation supporting accurate coding decisions

Who Should Attend

• Medical Billing Specialists
• Medical Coders (CPC, CCS, RHIT)
• Practice Managers
• Revenue Cycle Managers
• Compliance Officers
• Gastroenterology Office Staff
• Healthcare Administrators
• Claims Processors

Why This Training Matters

Colonoscopy screening is one of the most frequently billed procedures in gastroenterology, yet it's also one of the most complex when it comes to coding and reimbursement. With frequent policy updates and significant differences between Medicare and commercial payer requirements, accurate coding is essential to:

• Maximize Revenue: Ensure you're capturing all billable services
• Reduce Denials: Understand payer-specific requirements before submitting claims
• Maintain Compliance: Stay current with CMS guidelines and commercial payer policies
• Improve Cash Flow: Reduce reimbursement delays through proper coding

Format

Live interactive webinar with Q&A session included

What's Included

• Live expert instruction
• Comprehensive course materials
• Real-world coding examples
• Q&A opportunity with the instructor
• Access to recording (available for 3 days after the event)
  
  Don't let coding confusion cost you revenue. Register today and gain the confidence to handle colonoscopy claims accurately and efficiently!