ACG Practice Management Toolbox
NEW! Members Only – ACG’s Billing and Coding Forum

We heard you! ACG members and GI practices continue to face mounting financial and reimbursement pressures. Complex coding and documentation requirements only add to these burdens. The ACG Practice Management Committee is pleased to announce the new member benefit: professional coding and documentation assistance for ACG members, tailored to your individual practice’s questions and needs.

Arlene Morrow

Arlene Morrow, CPC, CMM, CMSCS is now available to answer your questions!

Have a question? Email coding@gi.org – ACG members will receive an answer and guidance within a few business days.

Medicare Coding Look-Up

Have a question on a particular Medicare physician fee schedule (PFS) code and reimbursement in your practice area? CMS provides a tool for physicians and practice managers to help answer coding and other reimbursement information in the Medicare PFS.

To access the CMS Physician Fee Schedule Search Tool, visit: www.cms.gov/medicare/physician-fee-schedule/search.

GI Moderate Sedation

ACG Guidance on GI Moderate Sedation and GI Anesthesia Changes — What Do You Need to Know?

GI Moderate Sedation

In 2017, CMS announced changes regarding moderate sedation for certain GI procedures. These changes remain the same for 2018. If you administer moderate sedation while performing certain GI endoscopic procedures, Medicare requires ACG members to report 2 codes on Medicare claims for endoscopic procedures — the code for the endoscopic procedure and a GI-specific moderate sedation code (G0500). If you use an anesthesia professional, you can simply report the procedural code as you have previously done.

Check out ACG’s Moderate Sedation Summary and Educational Tool. ACG has created a summary of these changes and a chart of impacted codes.

GI Anesthesia Changes

Beginning 2018, the following GI anesthesia codes will be deleted: CPT codes 00740 (Anesthesia for upper GI procedures) and 00810 (Anesthesia for lower GI procedures). The CY 2017 base unit for both upper and lower GI services was 5 base units. These codes will be replaced with 5 new codes:

  • 00731 (Anesthesia for upper GI, not otherwise specified) = 5 base units
  • 00732 (Anesthesia for upper GI, ERCP) = 6 base units
  • 00811 (Anesthesia for lower GI, not otherwise specified) = 4 base units
  • 00812 (Anesthesia for screening colonoscopy) = 3 base units
  • 00813 (Anesthesia for upper and lower GI during the same session) = 5 base units

Each base unit is approximately $22.