Gastroenterology Billing
Screening-vs-diagnostic colonoscopy logic, endoscopy hierarchies and anesthesia coordination — GI billing done carefully.
GI billing is won or lost on intent: a colonoscopy that begins as screening and finds a polyp changes category mid-procedure, and payers apply different cost-sharing and coding rules to each path. Elite Bill Care's gastroenterology billing manages those distinctions daily.
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GI billing specifics
- Screening vs. diagnostic — Medicare and ACA-plan rules for screening colonoscopy, the PT modifier when screening converts to therapeutic under Medicare, and preventive-services modifier 33 under commercial rules.
- Endoscopy hierarchies — multiple procedures in one session (EGD with biopsy, colonoscopy with polypectomy) priced under family and multiple-endoscopy rules, not simply stacked.
- Anesthesia coordination — endoscopy anesthesia codes (00731/00811–00813 family) and payer policies on propofol/MAC coverage by indication.
- Pathology flows — specimen counts and outside pathology coordination without duplicate professional charges.
- Office GI — hepatitis and IBD management visits, infusion/injection therapies for biologics with J-code discipline and authorization tracking.
How we run it
Procedure reports are matched to claims under coding support — indication, findings and technique reconciled before submission; screening-intent documentation is checked because it decides the patient's cost share and your denial risk. Denials work through denial management. Full picture: our billing services page.
Frequently asked questions
Do you bill for ASC facility settings as well as hospital and office?
We bill professional GI services across settings with correct POS; facility-fee billing depends on your ASC arrangement — ask us and we will map it.
Can you handle our biologic infusion billing?
Yes — authorization, J-code units and administration hierarchy included, coordinated with your buy-and-bill inventory practices.