Gastroenterology Billing That Pays What You Earn
Gastroenterology billing is dominated by endoscopic procedure coding — colonoscopy, upper endoscopy, ERCP — where the difference between screening, diagnostic, and therapeutic codes can mean hundreds of dollars per procedure. Incomplete polyp documentation, missed add-on codes, and incorrect screening-to-diagnostic conversion are the most expensive billing errors GI practices make. 360Solutions provides GI-specialised billers who maximise procedure revenue, manage prior auth, and keep colonoscopy conversion coding compliant.
Where Gastroenterology Practices Lose Revenue
These are the coding and billing pitfalls that cost gastroenterology practices the most — and where our specialised billers add the most value.
Screening-to-Diagnostic Conversion
When a screening colonoscopy becomes therapeutic (polyp removal), the code must convert from 45378 to 45380/45385. Failing to convert — or converting incorrectly — costs the practice the additional procedure value and risks compliance exposure.
Polyp Pathology Coordination
Colonoscopy coding depends on what was removed and how — cold snare, hot biopsy, EMR. Coders must wait for pathology results to assign definitive codes. We manage the pathology coordination workflow to ensure no claims are billed prematurely.
ERCP Bundling Complexity
ERCP codes (43260–43278) include numerous add-on codes for sphincterotomy, stent placement, stone extraction, and biopsy. Each service must be coded separately or bundled per NCCI rules. Errors here cost $200–800 per procedure.
Anesthesia Coordination
GI endoscopy often uses monitored anesthesia care (MAC) or propofol sedation. Professional anesthesia billing must be coordinated with the GI procedure claim to prevent duplicate billing and ensure correct POS codes.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Gastroenterology.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
Screening colonoscopy not converted to therapeutic code after polyp removal
Colonoscopy add-on code billed without the primary endoscopy code
ERCP stent placement billed without documented stent type and size
Anesthesia and GI procedure billed by same provider (duplicate billing flag)
Prior auth not obtained for advanced endoscopic procedures (ESD, EMR)
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Gastroenterology Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in gastroenterology coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Gastroenterology Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified gastroenterology billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.