- Gastroenterology Coding Specialists
Gastroenterology Medical Billing Services
Gastroenterology billing is procedurally complex. One wrong colonoscopy modifier, one missed polyp removal code, or one bundled procedure—and thousands in revenue vanish.
Neo MD fixes that with gastroenterology-certified coders, endoscopy-specific coding workflows, and aggressive procedure capture built for GI complexity.
96-98%
First-Pass Claim
+28%
Avg Revenue Increase
90
Days to Results
- Practice Revenue Health Audit
Is Your Gastroenterology Practice
Bleeding Revenue? (Most Are.)
If you fall behind your revenue goals, it’s time to get our professional consultation about the Revenue Cycle Management process. If any of these are happening, you’re losing $180K–$420K+ annually:
Visible Revenue Bleed
Immediate Impact
Colonoscopy Claims Denied
Screening vs diagnostic coding documentation gaps
Polyp Removal Claims Rejected
The technique and size documentation are insufficient
EGD Claims Denied
Missing medical necessity for repeat procedures
Biologic Infusion Claims Delayed
Prior authorization failures for Remicade/Entyvio
Multiple Polyp Removal Claims Bundled
When different techniques should've been billed
Anesthesia Modifier Violations
Wrong modifier on procedures requiring sedation
Invisible Losses
According to ACG and MGMA gastroenterology benchmarking data, practices lose 18%–25% of revenue due to:
PT modifier missing when polyps are found
Screening to Diagnosis
Hot biopsy vs snare vs EMR coding
Polyp Removal Technique
Undercounting separate polyps
Multiple Polyp Documentation
Not billing biopsies separately
EGD with Biopsy
Wrong drug units or wastage
Biologic J-Code Errors
Missing multiple band documentation
Hemorrhoid Banding
Not billing savary vs balloon separately
Esophageal Dilation
Missing professional interpretation
Capsule Endoscopy
"You didn't train for 10+ years to fight with insurance companies. But right now, coding errors cost more than a gastroenterologist's salary."
$420,000+
- Industry Problem
Why General Medical Billing Companies Fail Gastroenterology Practices
Gastroenterology billing requires specialty expertise that general billers don’t have.
Screening vs diagnostic chaos
Don't apply PT modifier when findings change status
Polyp technique blindspot
Can't distinguish hot biopsy, snare, EMR codes
Multiple polyp confusion
Don't count and code separate polyp removals
EGD biopsy miss
Bundle biopsies that should bill separately
Biologic infusion errors
Miscalculate drug units and wastage
Medical necessity gaps
Can't document repeat endoscopy justification
Hemorrhoid procedure underbilling
Don't capture multiple band placements
Anesthesia modifier mistakes
Don't coordinate with anesthesia billing
Result: 15%–22% denial rates, 45-60 day payment cycles, and constant staff time wasted on resubmissions.
- The NEO MD Difference
The Neo MD Gastroenterology Advantage
Gastroenterology-Certified Coding Teams
- Expert in colonoscopy coding (screening vs diagnostic, multiple polyps)
- EGD procedure optimization (biopsy sites, dilation, ablation)
- ERCP component billing (sphincterotomy, stent, stone extraction)
- Complex endoscopy procedures (EMR, ESD, EUS)
- IBD infusion therapy billing
- Anesthesia modifier accuracy (33, 77, PT)
→ 96–98% clean claim rate vs 60–73% industry average
Endoscopy Procedure Revenue Maximization
We ensure proper billing for
- Multiple polyp removals with correct additional codes
- Screening to diagnostic conversion with PT modifier
- Same-day multiple endoscopy procedures (upper and lower)
- Complex therapeutic procedures (EMR, band ligation, ablation)
- Foreign body removal and dilation procedures
- Hemostasis and control of bleeding codes
→ $18K–$38K monthly recovery from endoscopy optimization
Complete Prior Authorization Management
We handle authorizations for:
- Colonoscopy (screening and diagnostic)
- Upper endoscopy procedures
- ERCP and EUS procedures
- Capsule endoscopy
- Infusion therapy (Remicade, Entyvio, Stelara)
- Advanced imaging (CT enterography, MR enterography)
→ 3.8-day turnaround instead of 9–14 days
ERCP & Advanced Procedure Coding
We optimize billing for:
- ERCP with sphincterotomy, stent placement, stone extraction
- Endoscopic ultrasound (EUS) with FNA biopsy
- Endoscopic mucosal resection (EMR)
- Radiofrequency ablation (RFA) for Barrett's esophagus
- Variceal band ligation
- PEG tube placement and replacement
→ Appropriate reimbursement for complex procedures
IBD Infusion Therapy Revenue
We capture:
- Biologic infusion administration codes (96413, 96415)
- Drug supply codes (J-codes for Remicade, Entyvio, Stelara)
- Prolonged infusion services
- Observation for infusion reactions
- Pre-medication administration
→ $12K–$26K monthly from infusion services
Real-Time Revenue Visibility
Expert navigation of:
- Daily endoscopy procedure claim tracking
- Weekly colonoscopy coding accuracy monitoring
- Monthly financial performance by procedure type
- Quarterly payer policy update reviews
→ Complete transparency
Gastroenterology Services We Master
Colonoscopy Services
Screening colonoscopy for average and high-risk patients with proper modifier application, diagnostic colonoscopy for symptoms or abnormal findings, colonoscopy with polypectomy including hot biopsy forceps and snare techniques, multiple polyp removals with correct additional code billing, colonoscopy with tumor ablation or control of bleeding, and flexible sigmoidoscopy procedures with or without biopsy.
Upper Endoscopy Procedures
Esophagogastroduodenoscopy (EGD) with comprehensive examination, EGD with biopsy from multiple sites documented separately, esophageal dilation for strictures using bougie or balloon techniques, variceal band ligation for bleeding varices, foreign body removal from esophagus or stomach, and ablation therapy for Barrett’s esophagus using radiofrequency or cryotherapy.
ERCP & Biliary Procedures
Endoscopic retrograde cholangiopancreatography (ERCP) with diagnostic imaging, sphincterotomy for biliary or pancreatic access, biliary stent placement for obstruction or stricture, stone extraction from the bile duct using a basket or balloon, pancreatic duct stent placement, and nasobiliary or nasopancreatic drain placement.
Advanced Endoscopy
Endoscopic ultrasound (EUS) for staging and evaluation, EUS-guided fine needle aspiration (FNA) of masses or lymph nodes, endoscopic mucosal resection (EMR) for early cancers or large polyps, endoscopic submucosal dissection (ESD) for complex lesions, PEG tube placement and replacement procedures, and capsule endoscopy for small bowel evaluation.
Infusion Therapy
Biologic infusion administration for Crohn’s disease and ulcerative colitis, including Remicade, Entyvio, Stelara, and other biologics, pre-medication administration and monitoring, infusion reaction management, observation services during and after infusion, and drug supply billing with appropriate J-codes.
Office-Based Services
Consultations for new GI complaints and complex digestive disorders, follow-up management for IBD patients with medication adjustments, liver disease monitoring and management, functional GI disorder evaluation and treatment, nutrition and dietary counseling for GI conditions, and hemorrhoid banding procedures in office setting.
Real Results: 5-Physician Gastroenterology Group (Florida)
“We were systematically undercoding every multi-polyp colonoscopy. Neo MD fixed our ERCP billing, helped us launch infusion therapy services, and eliminated our screening vs diagnostic errors. Our revenue is up 34% without adding procedures.”
— Dr. Steven H., Gastroenterologist
| Metric | Before NEO MD | After NEO MD (90 Days) |
|---|---|---|
| Denial Rate on Colonoscopy Procedures | 32% | 3.4% |
| Annual Revenue Loss | $680,000 | Recovered |
| Multiple Polyp Removal Coding | Consistently Undercoded | +$22,000 / month |
| ERCP Component Billing | Bundled Incorrectly | +$18,000 / month |
| Infusion Therapy Billing | $0 Revenue | +$15,000 / month |
| Screening vs Diagnostic Modifier Accuracy | Frequent Errors | +$12,000 / month |
| Total Revenue Impact | Missed Revenue |
$78,000 / month ($936K annually) |
Free Download
Gastroenterology Denial Prevention Checklist
The exact checklist our coders use for 96%+ clean claims.
Colonoscopy coding decision tree (screening vs diagnostic, PT modifier rules)
Multiple polyp removal billing matrix (45384, 45385 with documentation requirements)
ERCP component coding guide (sphincterotomy, stent, stone, dilation combinations)
EGD biopsy site documentation template (separate anatomic locations)
Screening to diagnostic conversion worksheet (when PT modifier applies)
Infusion therapy billing guide (J-codes, administration codes, time tracking)
Same-day multiple endoscopy modifier rules (modifier 51, 59)
Medical necessity templates for repeat endoscopy procedures
Used by 165+ gastroenterology practices. Worth $2,900. Yours free.
Performance: Neo MD vs Industry Standard
| Metric | Industry Avg | NEO MD |
|---|---|---|
| Clean Claim Rate | 60–73% | 96–98% |
| Denial Rate | 27–40% | 3–6% |
| Multiple Polyp Coding Accuracy | 48–64% | 97%+ |
| ERCP Component Accuracy | 52–69% | 96%+ |
| Screening vs Diagnostic Accuracy | 68–79% | 98%+ |
| Infusion Therapy Capture | 22–45% | 94%+ |
Our Process: Our 90-Day Revenue Acceleration Process
We begin with a comprehensive analysis of your last 90 days of billing data, examining every colonoscopy procedure for multiple polyp coding accuracy, screening versus diagnostic classification, and PT modifier application. Our team reviews ERCP procedures for component billing optimization, evaluates EGD coding for biopsy site documentation, and assesses infusion therapy revenue capture opportunities. You receive a detailed report showing exactly where revenue is leaking with specific examples of undercoded procedures and the dollar amount being lost to each type of coding error or missed service opportunity.
Our implementation team coordinates a smooth transition with zero disruption to your endoscopy schedule or patient care. We integrate with your EMR and endoscopy reporting system (whether you're using Provation, Pentax, EndoWorks, Epic, or any other platform), verify all payer enrollments and credentialing including ASC facility contracts, set up endoscopy-specific coding protocols with automatic polyp count capture, establish screening versus diagnostic determination workflows, and provide comprehensive training to your physicians, endoscopy nurses, and billing staff on documentation requirements for multiple polyps, ERCP components, and infusion therapy billing. Most practices have their first clean claims submitted within 10-12 business days.
This is where you see immediate financial impact. Our certified gastroenterology coders begin capturing every additional polyp removal code on multi-polyp colonoscopies, implementing correct ERCP component billing for sphincterotomy, stent, and stone extraction procedures, optimizing screening to diagnostic conversions with proper PT modifier application, and launching or optimizing infusion therapy billing for IBD patients with complete drug supply and administration coding. We systematically rework and resubmit old denied claims with corrected coding and enhanced procedure documentation. Within the first 30 days, most practices see noticeable cash flow improvement from multiple polyp optimization alone, and by day 90, our clients average a 27-32% revenue increase without adding endoscopy time slots or performing more procedures.
Revenue optimization doesn't stop at 90 days. We provide bi-weekly updates on colonoscopy screening guideline changes and payer policy modifications, conduct monthly endoscopy coding reviews with your providers to ensure continued documentation accuracy for polyp size and location, perform quarterly compliance audits on screening versus diagnostic classifications and ERCP component coding, and deliver annual CPT code update training specific to gastroenterology and endoscopy services. As your practice adds new procedures like endoscopic mucosal resection, radiofrequency ablation, or new biologic infusions, we proactively research coverage policies and implement billing protocols to ensure maximum reimbursement from day one.
Critical Compliance Issues We Handle
Gastroenterology practices face unique compliance challenges. We protect you:
Screening vs diagnostic colonoscopy rules
PT modifier, diagnosis code requirements
Multiple polyp documentation
size, location, technique for each polyp
ERCP component coding accuracy
bundling rules, separately billable services
Medical necessity for repeat procedures
supporting documentation, appropriate intervals
Same-day multiple endoscopy modifiers
modifier 51, 59 appropriateness
EGD biopsy site documentation
separate anatomic locations required
Anesthesia modifier 33 compliance
screening colonoscopy, preventive services
Infusion therapy medical necessity
diagnosis support, frequency limitations
We keep you compliant, paid, and audit-ready.
Frequently Asked Questions
10–14 days, zero claim disruption.
Yes. We work with Provation, Pentax, EndoWorks, and all major endoscopy documentation platforms.
We handle all PT modifier scenarios and ensure proper diagnosis code changes.
6–9% of collections, but clients average 27–32% revenue increase.
Yes. We handle both office-based and ASC billing models, including facility fee coding.
We optimize infusion billing including drug supply codes (J-codes) and administration services.
- Financial Attrition Warning
Stop Losing $28K–$68K Every Month
Every month you delay is another month of compounded clinical leakage.
Multiple polyps undercoded
ERCP components bundled
Screening/diagnostic errors
EGD biopsies underbilled
Infusion therapy = $0
Complex procedures missed
Partner with Neo MD
Operational Performance Protocol
Infusion capture
94%+
Two Ways to Get Started
Option 1
Free Revenue Analysis
No obligation. No sales pitch. Just data.
We’ll show you:
- Multiple polyp coding accuracy on colonoscopies
- ERCP component billing optimization opportunities
- Screening vs diagnostic classification errors
- EGD biopsy site documentation gaps
- Infusion therapy revenue potential
- Missed revenue by procedure type
Option 2
Talk to a Specialist
15-minute consultation. Zero pressure.
We’ll discuss:
- Your current billing challenges
- Colonoscopy and endoscopy coding gaps
- ERCP and infusion billing opportunities
- Whether Neo MD is the right fit
Or call us directly:
- (929) 502-3636
Monday-Friday, 8 am-5 pm EST
The Cost of Waiting
If you’re a gastroenterology practice collecting $4.2M annually and losing 29% to billing inefficiencies:
$1,218,000
Annual revenue loss
$6.09 million
5-year total loss
That’s hiring another gastroenterologist, opening your own ASC, investing in advanced endoscopy equipment like EUS or confocal imaging, or launching comprehensive IBD infusion services.
Every month you wait costs you $101,500 you'll never recover.
The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”
NEO MD Inc. | Gastroenterology Medical Billing Specialists
Trusted by 165+ gastroenterology practices across all 50 states.