Expert billing for GI practices — from colonoscopy and endoscopy coding to denial management and credentialing. Serving practices nationwide across the United States.
Get Free Practice Audit Contact UsComprehensive billing coverage for your specialty
Accurate CPT coding for diagnostic and therapeutic colonoscopies, upper endoscopies, ERCP, and EUS with proper modifier application.
Complete billing for liver biopsies, capsule endoscopy, hemorrhoid procedures, polyp removal, and all GI interventional procedures.
GI claims are frequently denied for bundling and medical necessity. We proactively appeal and recover all denied claims.
Provider enrollment with Medicare, Medicaid, and all commercial payers for gastroenterologists and GI groups.
Managing prior auth requirements for advanced GI procedures to prevent denials before they happen.
Monthly reports on your GI practice financial performance with actionable insights.
Gastroenterology is one of the most denial-prone specialties in medicine. GI practices live on procedures — colonoscopies, EGDs, ERCPs, capsule studies — and every one of them sits at the intersection of screening-versus-diagnostic rules, payer-specific bundling edits, and strict medical-necessity requirements. A billing team that treats GI claims like generic office visits will leak revenue every single week. Here is how we approach the parts of GI billing where practices lose the most money.
The single most common GI billing error is mishandling a screening colonoscopy that converts to diagnostic when a polyp is found. Commercial payers generally require modifier 33 and Medicare requires modifier PT to preserve the patient's zero-cost-share screening benefit. Get it wrong and the patient receives a surprise bill, your front desk fields angry calls, and the claim often ends up reprocessed or written off. We apply conversion modifiers correctly on every claim and verify each payer's screening policy before submission.
Same-session procedures — an EGD and colonoscopy performed together, or multiple techniques used on the same lesion — trigger National Correct Coding Initiative edits constantly. Multiple endoscopy payment rules reduce reimbursement on secondary procedures, and careless use of modifier 59 or XU to force claims through is one of the fastest ways to attract a payer audit. Our coders apply bundling logic the way payers expect it, so claims are paid correctly the first time and stand up to review.
A single colonoscopy can generate three or four separate claims: the professional fee, the ASC or hospital facility fee, anesthesia, and pathology. When those claims don't line up — mismatched diagnosis codes, different service dates, missing anesthesia documentation — payers deny some or all of them. We reconcile every component of the encounter so the whole episode is billed consistently and nothing falls through the cracks.
Payers enforce strict frequency limits on surveillance colonoscopy for conditions like Barrett's esophagus, IBD, and personal history of polyps. If the documented interval or indication doesn't match the payer's policy, the claim denies for medical necessity. We flag interval and indication problems before submission and give your providers concise documentation feedback instead of letting the same denial repeat every month.
Onboarding a GI practice typically takes five to ten business days. We connect to your existing EHR and practice-management system, run in parallel with your current process during transition, and take over the full cycle — eligibility, prior authorization, coding, submission, posting, denials, and patient statements — with zero downtime for your schedule. There are no long-term contracts, and you can start with a free one-week billing audit of your recent claims.
Patients asking what it costs? Our colonoscopy cost guide covers cash pricing and the screening-versus-diagnostic coding question.
Specialties tied to GI by endoscopy sedation, screening rules and cancer pathways.
Endoscopy sedation generates a paired claim on nearly every procedure, with its own coverage rules.
Colorectal and hepatic cancer pathways run between the two, from screening through surveillance.
Imaging supports most GI workups, and professional/technical splits have to be billed cleanly.
Independent GI practices carry the same overhead and outsourcing questions as any small practice.
We bill all of these in house. If your group spans several of them, multi-specialty billing keeps one team across every line — or see the full list of services.
Get a free billing audit and see how much more your gastroenterology practice can collect.
Get Free Practice AuditFree resources: Denial Code Lookup | RVU Calculator | AR Days Calculator | CO-236 — EGD/colonoscopy same-day edits