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Prior authorization continues to be one of the most significant operational challenges in endoscopic practice. Increasingly, payers use documented criteria — not necessarily clinical intuition — to adjudicate approval of endoscopy services.
Colorectal cancer (CRC) screening remains one of the most effective tools in preventive medicine. Yet even with multiple validated screening modalities and decades of clinical data, challenges persist.
A 59 year old female with history of long-term alcohol use and current tobacco use was seen in the clinic with complaints of epigastric abdominal pain, bloating, and weight loss. She reported her pain radiated to the back and worsened with heavy meals.
We have a patient who is having difficulty completing his SKYRIZI on-body injector at home and has asked whether he could come into the office for assistance. Is there a CPT billable code for a nurse-only outpatient visit to administer an injection?
As part of advocacy efforts to improve the Merit-based Incentive Payment System (MIPS) cost measures for physicians, your help is needed.
A 55-year-old male with PMHx HTN, HLD, Type III Achalasia underwent POEM (per oral endoscopic myotomy) one month ago and is now being seen in your clinic for scheduled follow up.
Are there any federal or payer requirements to keep hard copies of coding books at each practice? Our coding staff work remotely with current materials, and I haven’t found a rule requiring on-site copies.
We are seeing Cigna and other payers downcoding our claims. These were level 4 claims submitted with diarrhea, GERD, IBS, etc. What can we do to prevent this?
A 62-year-old, Caucasian male presents for a 6-month history of nausea and abdominal discomfort. He reports a 10-year history of heartburn at least 4 times per week, taking calcium carbonate for relief.
Is driving smarter capacity planning in 2026 part of your team’s playbook? Read on for responses from ASGE committee members who share their plans for stronger performance in the New Year.
Many of our providers are asking if they can bill for a telephone or audio only visit to discuss test results with patients. This ended in May 2025, and the current guidelines do not appear to support reimbursement.
This month’s case takes a different approach. Rather than focusing on a clinical scenario, we’re spotlighting leadership fundamentals for APPs and why they’re critical to the future of GI care.
Independent medical practices have long been the cornerstone of community-based care, offering patients personalized attention and continuity that large systems often struggle to provide.
Success reflects a collective effort as the course of 2025 reminded your GI colleagues. Read on for responses from ASGE committee members who share their lessons learned from the year.
Is there something (as a coder) that we can send on claims to avoid sequestration, reduction in federal payment?