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Gastroenterology Billing

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 Audit

We 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

The colonoscopy trap. A screening colonoscopy that becomes diagnostic (a polyp is found and removed) must be coded with modifier PT — so the patient isn't wrongly billed and the claim pays under preventive benefits. Getting this wrong causes denials and patient complaints.

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.