Gastroenterology Medical Billing Services
Gastroenterology billing turns on the screening-vs-diagnostic distinction and endoscopy bundling rules. Our certified coders specialize in GI so your colonoscopies, EGDs, and procedures are paid correctly.
Get a Free Gastroenterology Billing AuditWe handle gastroenterology billing end to end, endoscopic procedures, office visits, and infusions. Because GI revenue is concentrated in colonoscopy and endoscopy with intricate screening/diagnostic and bundling rules, a specialty-trained team is what prevents the denials and patient-billing errors common in the field.
Gastroenterology billing we handle
- Colonoscopy. Screening vs diagnostic coding with modifiers 33 and PT applied correctly.
- EGD & endoscopy. Upper endoscopy and procedures with correct bundling.
- ERCP & EUS. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound with correct component and fluoroscopy coding.
- Biopsies & interventions. Polypectomy, biopsy, and control-of-bleeding coded by method.
- Capsule endoscopy. Wireless capsule studies with the professional interpretation billed correctly.
- Motility & diagnostic testing. Esophageal manometry, pH and Bravo studies, breath testing, and flexible sigmoidoscopy.
- Infusions. Biologic infusions with correct hierarchy, units, and J-codes.
- Anesthesia coordination. Correct handling when a separate anesthesia provider is involved.
- Modifiers. 33 (preventive), PT (screening-to-diagnostic), 59, and 51 applied correctly.
Why gastroenterology practices lose revenue
The usual losses: screening-vs-diagnostic coding errors, missing modifiers 33/PT, endoscopy bundling mistakes, infusion hierarchy and unit errors, and wrong patient cost-sharing on preventive procedures. GI-trained coders handle each correctly.
What you get with PRMS
Screening/diagnostic accuracy
Colonoscopy coded with 33/PT so it pays correctly and patients aren't misbilled.
Endoscopy expertise
EGD, polypectomy, and interventions coded to method with correct bundling.
Infusion capture
Biologic infusions billed with correct hierarchy, units, and J-codes.
Gastroenterology billing FAQs
Why is gastroenterology billing complex?
GI revenue centers on colonoscopy and endoscopy, which carry intricate screening-vs-diagnostic rules, bundling edits, and modifiers (33, PT, 59). Small errors cause denials and incorrect patient billing.
How is a screening colonoscopy that becomes diagnostic billed?
With modifier PT (and correct diagnosis sequencing). This signals a screening procedure that converted to diagnostic, so it is processed correctly under preventive benefits and the patient is billed appropriately.
Do you bill GI infusions?
Yes. Biologic infusions are billed with the correct infusion hierarchy, units, and drug J-codes, with authorization obtained where required.
How soon will results show?
Most GI practices see cleaner endoscopy claims and fewer patient-billing errors within the first one to two billing cycles.
Related services & specialties
Explore our full billing, coding & denial management services and provider credentialing, or see other specialties including 25+ more.