Killer 01
Screening to diagnostic conversion mistakes
Modifier PT and preventive logic errors shift cost and reimbursement incorrectly.
GI billing that gets
screening vs diagnostic right.
Colonoscopy and EGD reimbursement depends on screening conversion logic, modifier use, and aligned documentation.
Aetnapaneled
BCBSpaneled
UnitedHealthcarepaneled
Cignapaneled
Humanapaneled
Kaiser Permanentepaneled
Tricarepaneled
Anthempaneled
Centenepaneled
Molinapaneled
Medicarepaneled
ElevancepaneledAetnapaneledBCBSpaneledUnitedHealthcarepaneledCignapaneledHumanapaneledKaiser PermanentepaneledTricarepaneledAnthempaneledCentenepaneledMolinapaneledMedicarepaneledElevancepaneledQuiet killers
Where gastroenterology revenue leaks. Three patterns we audit on every onboarding and fix first.
Killer 02
Polypectomy method miscoding
Technique-specific CPT selection materially changes reimbursement.
Killer 03
Anesthesia coordination gaps
Professional and anesthesia claims misalignment can deny both sides.
How we work
Gastroenterology operations, built right.
A specialty pod that lives inside your workflow, not a call-center model. These are the controls we run on every claim from day one.
Gastroenterology pod · operating playbookActive
01
Screening and diagnostic differentiation controls
✓02
Technique-based procedure coding
✓03
Pathology split handling
✓04
Anesthesia coordination workflows
✓Reviewed quarterly · last update May 2026v2.6
Codes & modifiers
The gastroenterology code family.
What we actively scrub on every claim. Coders in this pod work these codes daily with payer edits and documentation patterns mapped into weekly QA.
CPT/HCPCS reviewed quarterly · payer LCD/NCD subscriptions · CCI updates · claim-level audit logs.
45378
Diagnostic colonoscopy
45380
45384
45385
Snare polypectomy
G0105
G0121
Screening avg risk
43235
43239
33
PT
Screening converted to diagnostic
Credentialing
Panels we already work for gastroenterology. Enrollment, revalidation, and CAQH upkeep included.
✓Hospital privileges
✓ASC enrollment
✓Medicare and commercial paneling
FAQ
Frequently asked.
Practical questions we get during diligence. Ask anything we missed.
Do you support ASC, office, and hospital place-of-service logic?+
Yes.
Can you coordinate anesthesia billing?+
Yes.
Do you code capsule endoscopy?+
Yes.
30-day review
A quick conversation, not a long form.
Six short questions. We use them to route your request to the right specialist and return a focused recommendation summary.
HIPAA-safe by default
We don't ask for PHI. Practice-level data only.
~ 90 seconds
Press Enter to continue. No long intake form.
Based on what you've told us...
We route your request to the billing pod that can move fastest.