The American Medical Association (AMA) has announced the new Current Procedural Terminology (CPT) code changes for the year 2023, including updates for gastroenterology procedures. The changes will have a significant impact on healthcare providers and the way they bill for services. Ambulatory Surgery Centers (ASCs) should be aware of these changes in order to properly document and code gastroenterology procedures. At Medical Healthcare Solutions, we understand the importance of staying ahead of these changes and are here to provide an overview for ambulatory surgery centers (ASCs) and other healthcare providers in gastroenterology.
In this article, we will discuss the significant changes in the 2023 CPT codes that affect gastroenterology procedures and how ASCs can prepare for them.
Esophagoscopy and Gastroscopy
One of the major changes to the 2023 CPT codes is the addition of a new code for esophagoscopy and gastroscopy with biopsy. The new code is 43214 and replaces the existing code 43239. This new code includes the biopsy procedure, which was previously billed separately. This change will streamline the billing process and ensure that patients are not charged for separate procedures.
Another change is the deletion of code 43206, which describes the removal of esophageal tumor(s) by ablation with an endoscope. This code has been replaced with new codes that more accurately describe the specific ablation technique used.
For colonoscopies, the 2023 CPT code changes bring significant updates, particularly with the addition of two new codes. These codes address the specific procedures involved in the removal of lesions during a colonoscopy, which was previously not covered under existing codes. Understanding these new codes is crucial for accurate billing and appropriate reimbursement.
The first new code, 45345, specifically describes a colonoscopy with the removal of a lesion using the snare technique. This technique involves the use of a wire loop (snare) to effectively remove the lesion during the colonoscopy procedure. By introducing this code, healthcare providers can now properly document and bill for the snare technique when performed during a colonoscopy.
The second new code, 45346, pertains to a colonoscopy with the removal of a lesion using endoscopic mucosal resection (EMR). Endoscopic mucosal resection involves the removal of abnormal or pre-cancerous growths from the colon lining using specialized tools and techniques. With the inclusion of this code, providers can accurately capture and bill for the use of EMR during a colonoscopy.
Both of these new codes allow for the billing of lesion removal during a colonoscopy, providing healthcare providers with the ability to be properly reimbursed for these procedures. Previously, there was no specific code for billing the removal of lesions during a colonoscopy, which could lead to inaccuracies and potential loss of revenue.
For flexible sigmoidoscopies, the 2023 CPT codes will see the addition of a new code for biopsy. The new code is 45325 and replaces the existing code 45320. This change ensures that biopsy procedures are billed separately and not included in other codes.
Preparing for the Changes
To ensure proper billing, ASCs should begin preparing for the 2023 CPT code changes for gastroenterology procedures as soon as possible. ASCs should review their current billing and coding processes and update them to reflect the new codes. They should also ensure that their electronic medical record (EMR) systems are updated with the new codes to avoid any billing errors.
In addition, ASCs should provide training to their staff on the new codes and procedures to ensure that they are properly documented and coded. They should also work closely with their billing and coding professionals to ensure that they are following the proper guidelines and regulations.
In light of the upcoming 2023 CPT code changes for gastroenterology procedures, healthcare providers, particularly Ambulatory Surgery Centers (ASCs), need to be proactive in understanding and adapting to these changes. The impact of these updates cannot be understated, making it crucial for ASCs to take immediate action and prepare accordingly.
To navigate the shifting landscape, ASCs should prioritize reviewing their current billing and coding processes. This includes assessing the readiness of their Electronic Medical Record (EMR) systems to accommodate the new codes. Partnering with a trusted medical billing and coding solutions provider like Medical Healthcare Solutions can be immensely beneficial in this regard. Their expertise in medical billing and coding enables them to assist ASCs in effectively managing the transition and ensuring accurate documentation and coding practices.
Medical Healthcare Solutions can offer comprehensive assessments of ASCs’ current systems and workflows, identifying areas that require adjustment to align with the new CPT codes. Their team of professionals can guide ASCs in updating their EMR systems to incorporate the changes seamlessly. Moreover, they can provide valuable training to ASC staff members, equipping them with the knowledge and skills needed to properly document and code procedures using the new codes.
By partnering with us, ASCs can navigate the complexities of the 2023 CPT code changes with confidence. Their expertise and support will help ASCs optimize their billing and coding processes, ensuring accurate reimbursement and compliance with regulations. With a focus on delivering high-quality care to patients, ASCs can rely on Medical Healthcare Solutions to provide tailored solutions that meet their specific needs.