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Gastroenterology

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Gastroenterology

Deep Knowledge of GI-Specific Billing Needs GI billing is filled with nuances—from colonoscopies to sedation and pathology integration.

QuantumX provides:

  • Coding for EGD, colonoscopy, biopsy, and advanced endoscopy
  • Correct use of modifiers for incomplete or diagnostic procedures
  • Drug billing (e.g., sedation), pathology add-ons, and anesthesia tracking
  • Prior auth and payer-specific rules for screening vs. diagnostic services
  • Endoscopy and GI procedure coding expertise.
  • QuantumX supports gastro practices with accurate billing for colonoscopies, EGD, biopsies, and more. We manage sedation coding, pathology add-ons, and NCCI edits to minimize denials.
Billing Challenge QuantumX RCM Solution
Screening vs. diagnostic colonoscopy confusion Claims tagged with Z12.11 (screening) or K63.5 (diagnostic) + supporting symptoms.
Modifier -33 missing for ACA preventive services System flags eligible claims for automatic -33 application.
EGD+biopsy unbundling Ensures 43239 (with biopsy) is billed, not 43235 + 88305.
Missing facility fees for ASC procedures Separate charge capture for facility (e.g., C1713) vs. professional fees.
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