What Is Modifier PT? Modifier PT is a Medicare billing modifier that flags a colorectal cancer screening test that converted to a diagnostic or therapeutic procedure during the same visit,
What Are the New ESD CPT Codes for 2027? As of the CMS CY 2027 Physician Fee Schedule proposed rule, two new Category I CPT codes for endoscopic submucosal dissection
What Is the CMS Electronic Prior Authorization Rule for Drugs? As of September 2026, CMS has proposed requiring Medicare Advantage, Medicaid, and marketplace payers to support electronic prior authorization for
What Does the CMS Lab Fraud Crackdown Mean for Gastroenterology Billing? As of August 2026, CMS announced that its enforcement efforts have prevented or recovered more than $1.6 billion in
Created by: The Gastroenterology Billing Editorial Team, powered by Billing Service Quotes Technical Review: Tim Daniels, Director of Strategic Accounts, Billing Service Quotes Last Reviewed: August 2026 What Is ICD-10
How Does the 2026 Cyclospora Outbreak Affect Gastroenterology Billing? As of August 13, 2026, the CDC has confirmed 13,895 domestically acquired cases of cyclosporiasis across multiple states, compared to 1,180
What Is the G0121 CPT Code? G0121 is a Medicare HCPCS Level II code that reports a screening colonoscopy for an average-risk patient, meaning someone with no personal or family
What Is CPT Code 45380? CPT code 45380 is the gastroenterology procedure code for a flexible colonoscopy in which the physician advances the scope past the splenic flexure and removes
What Colonoscopy Billing Changes Take Effect in 2027? Two significant changes affect gastroenterology billing in 2027. First, the Medicare colonoscopy cost-sharing phase-down established by the Consolidated Appropriations Act of 2021
What are the 2027 ASC payment changes for gastroenterology? As of July 2026, the CMS calendar year 2027 OPPS and ASC proposed rule, CMS-1850-P, would raise overall ambulatory surgery center
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