Trusted Gastroenterology Billing Experts Backed by Real Results
We help gastroenterology providers boost collections, reduce denials, and clean up aged AR without requiring any changes to your EHR or workflow.
- Increase revenue up to 30% with specialty-focused billing workflows
- 98.9% first pass rate for faster insurance reimbursements
- Recover 120+ day AR without chasing payers yourself
- 24/7 access to a dedicated team of GI billing experts

Rapid Revenue Recovery
Revenue Increase
Denial & Rejection
Short Turnaround Time
Electronic Claim
Electronic Payment
Client Retention
First-Pass Resolution
We're here to help We’re available 24/7 – Schedule a call with one of our experts now.
Why Leading Gastroenterology Practices Trust Us to Handle Their Billing
Specialty-Focused Billers & Coders
GI-trained professionals who know exactly how to handle procedures like colonoscopies, biopsies, and endoscopies using the correct CPTs and modifiers.
EHR + PM Integration
We plug into your existing systems like eClinicalWorks, Kareo, or DrChrono so there’s no disruption to your front office.
Real-Time Denial Prevention
Proprietary checks and expert reviews catch errors before payers do, reducing rework and delays.
Aggressive A/R Recovery
We follow up on unpaid claims over 120 days with dedicated escalation, helping you unlock stuck revenue.
What You Can Expect When We Handle Your GI Billing
From onboarding to monthly reporting, every step of our partnership is designed to keep you in control while we handle the heavy lifting.
Our Gastroenterology Billing experts, with their unwavering dedication, help you achieve your financial goals.
As a prominent Gastroenterology Billing Service provider, our primary mission is to offer comprehensive gastroenterology billing services to healthcare practices across the Nevada. Our approach is specialized in improving the revenue cycle and addressing the common billing challenges that gastroenterology physicians often face. Our Las Vegas GI Billing Services ensure a potential increase in your revenues.
Proven Results for Gastroenterology Practices Across U.S
GI Practices Served
48+
First Pass Resolution Rate
99%
Average Revenue Increase
20%
How We Keep Revenue Flows Smooth
- Patient Intake and Eligibility Verification :We verify insurance coverage, patient demographics, and authorization requirements upfront to reduce rejections and delays. Clean data in means faster payments out.
- Specialty Coding for Gastroenterology Services :Our certified coders are trained specifically in GI procedures like colonoscopies, biopsies, and endoscopies. We ensure accurate CPTs, ICD-10 codes, and modifiers are applied based on payer guidelines.
- Daily Claim Submission and Payment Posting: We handle daily claim scrubbing, submission, and payment posting to maintain a steady cash flow and reduce backlog. You’ll always know what’s been billed and what’s been collected.
- Denial Management and Aged AR Recovery : Our team aggressively follows up on denials and aged claims over 30, 60, and 120 days. We work every claim until it’s resolved, so no revenue slips through the cracks.
Statistics That Define Our Company
48
Serving States
35 +
Specialties
1,200 +
Healthcare Providers
97 %
Claim Acceptance rate
100 %
Compliance
Frequently Asked Questions
We’ve have compiled a list of commonly asked questions to provide you with quick and informative answers.
Gastroenterology involves a broad spectrum of procedures. Each procedure has a specific CPT code assigned to it. Mentioned below are some gastroenterology procedures with their CPT codes
- Colonoscopy 45378, 45380, 45385, 45388, 45384.
- Esophagogastroduodenoscopy (EGD) 43235, 43239, 43250.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) 43260, 43261, 43265.
- Endoscopic Ultrasound (EUS) 43231, 43237.
- Capsule Endoscopy 91110.
- Sigmoidoscopy and Proctosigmoidoscopy 45330, 45331, 45333.
It is important to realize that every procedure has a unique CPT code. These codes vary based on complexity of the procedure, techniques
used, and the extent of examination required to perform the procedure. It is recommended to refer to the most current CPT code references
and guidelines to obtain the latest information on coding gastroenterology procedures.
The Modifier is additional information regarding the specific aspect of a medical procedure or service. It is a two-character code added to Current Procedural Terminology (CPT) or Health Common Procedure Coding System (HCPCS) to reflect the specific circumstance of the procedure performed. Incorrect use of modifiers may lead to claim denials and lower reimbursement rates. Some of the key modifiers used in gastroenterology billing are mentioned below.
- Modifier-22 for Increased Procedural Services.
- Modifier-51 for Multiple Procedures.
- Modifier-52 for Reduced Services.
- Modifier-53 for Discontinued Procedure.
- Modifier-59 for Distinct Procedural Service.
- Modifier-99 for Multiple Modifiers.
ICD-10 codes describe patients’ diagnosis whereas CPT codes are the prescribed procedures or services performed to treat the condition. Both types of codes are essential in accurate billing and documentation in gastroenterology and other medical specialties.
- ICD-10 codes inform about diagnostic information, while CPT codes convey procedural or service-related information.
- ICD-10 codes are alphanumeric (e.g., G11.0), whereas CPT codes are numeric (e.g., 45378).
- ICD-10 codes are on the patient’s condition, disease, or diagnosis, while CPT codes focus on the services provided by the healthcare provider.
- ICD-10 codes support medical necessity and justify the need for specific procedures. CPT codes are used to identify the specific procedures or services performed.
- ICD-10 codes are linked to CPT codes in medical billing to show the relationship between the patient’s diagnosis and the procedures or services rendered.
For Medicare beneficiaries and other private payers, screening colonoscopies are generally billed with CPT code 45378. The ICD-10 code that indicates the patient’s intention for a screening exam is Z12.11 (Encounter for screening for malignant neoplasm of the colon).
The CPT code used for a diagnostic colonoscopy is typically 45380 (Colonoscopy, flexible, with single or multiple). The ICD-10 codes should be selected based on the patient’s symptoms or indications, such as codes related to specific GI conditions or symptoms (e.g., abdominal pain, rectal bleeding).
Gastroenterology billing services under Medicare and Medicaid have unique rules and variations among states. A successful billing practice needs to stay informed and follow guidelines to accurately maintain documentation.
Medicare Billing for Gastroenterology Services
- Ensure that the healthcare practice is enrolled as a Medicare provider and that all gastroenterologists are properly credentialed with Medicare.
- Verify the patient’s Medicare eligibility and coverage to avoid claim denials.
- Correct usage of Medicare-specific modifiers when applicable
- Comply with Medicare billing rules and regulations to avoid audits and penalties.
Medicaid Billing for Gastroenterology Services
- Ensure that the healthcare practice is enrolled as a Medicaid provider in the state’s Medicaid program.
- Determine if prior authorization is required for specific gastroenterology procedures or services and obtain it as necessary.
- Stay in compliance with Medicaid guidelines of the state for Billing codes, modifiers, and any specific requirements.
- Ensure claims are submitted within the specified timeframes.
- Stay updated on Medicaid policies through provider training sessions.
Evaluation and Management (E/M) service is based on several factors, commonly referred to as “Three Key Components” and “Medical Decision Making. To determine the appropriate E/M level for office visits, the following procedures must be put in place.
Three Key Components
Evaluate Patient’s history by documenting chief complaint, history of present illness (HPI), review of systems (ROS), and past medical and social history (PFSH). Perform physical examinations relevant to patients’ complaints. The extent of the examination should be commensurate with the complexity of each case.
Medical Decision Making (MDM)
Medical Decision-Making process includes
- The number and complexity of the patient’s problems addressed during the visit.
- The amount and complexity of data reviewed (e.g., test results, imaging).
- The risk of complications, morbidity, or mortality is associated with the patient’s condition.
Selecting the Appropriate E/M Level
The E/M levels are typically categorized into five levels, level 1 being the lowest complexity to level 5 being the highest complexity.
Yes, when billing gastroenterology service, several compliances, and regulations are set in place to ensure proper and ethical billing practices.
- Avoid any payments or agreements that are prohibited under the AKS.
- Comply with Stark Law, which prohibits referrals for certain designated health services, including certain gastroenterology procedures.
- Adhere to CPT and ICD-10 guidelines.
- Support the codes billed with relevant documents.
- Follow specific regulations and guidelines when billing for services provided to Medicare and Medicaid beneficiaries.
- Ensure patient information is protected and that they comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations.
- Implement NCCI edits to ensure that procedures are correctly bundled or unbundled based on CMS guidelines.
- Use modifiers to convey information for specific circumstances.
To avoid claim denials it is essential to ensure complete and accurate patient information, verify insurance coverage and use appropriate codes and modifiers. Prior Authorization (PA) and Verification of Benefit (VOB) help to avoid claim rejections and give a clear image of the financial obligations.
Our Solutions
Our advanced Infrastructure and Strategies are designed to determine issues in your Revenue Cycle Management and improve them with precisely streamlined processes. We recognize that healthcare providers face a variety of challenges, including missed charges, under pricing, non-reimbursed errors, coding errors, and more, which can lead to significant revenue loss each year.
Therefore, we have designed our Medical Billing & Coding Services as well as Physician Credentialing to prevent any discrepancies and provide accurate deliverables, ultimately helping healthcare providers achieve optimal Revenue generation
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Our Esteemed Clients' Testimonials
Pro Medical Billing Solutions is doing an incredible job of boosting our revenue and improving our cash flow. They are excellent at communicating with the insurance providers and are prompt in addressing issues. We're immensely grateful for their wonderful efforts, and we give a thumbs-up to their entire team.
For the past 15 months, Pro Medical Billing Solutions has consistently delivered incredible collection results, with first-pass rates surpassing industry standards. Their high responsiveness and effective Revenue Cycle Management services make them the go-to choose for any practice looking to take control of their billing.
We rely on Pro MBS for our medical billing operations and analysis. Our collaboration with Pro MBS has allowed us to excel over the last five years. We had a few patients’ inflows initially, and we ended up getting many more clients, Pro MBS helped us scale.
Thanks to Pro Medical Billing Solutions, our practice has seen a significant improvement in our billing and collection processes. Their team is always up-to-date with the latest industry changes, and they have provided excellent support to our staff. We would highly recommend their services to any healthcare provider.
We have been using Pro Medical Billing Solutions for several months, and we have been extremely satisfied with their services. They have helped us to optimize our billing and coding practices, resulting in improved cash flow for our practice. We highly recommend them to other healthcare providers.
Pro MBS has provided excellent satisfaction for our Medical Billing and Coding operations. We conduct regular meetings with their team. They are updated with current industry trends and keep very high standards for quality service. We consider them as an extension of our business office.
Pro Medical billing Solutions has numerous strengths. One of many is effective communication, which kept me aware of billing updates and claim processes. I am impressed with the swift claim processing and the turnaround time for claims. appreciate Pro Medical Billing Solutions for providing constant support.
We are pleased with Pro Medical Billing Solutions' billing and coding services and highly endorse them to anyone looking for a proficient billing company. Collaborating with Pro Medical Billing Solutions has been effortless, and we are deeply grateful for their services.
As the CEO of Big Dog Pharma, I would highly recommend Pro Medical Billing Solutions for your Medical Billing and Coding processes. Over the past four years of collaboration, I have found them responsive, prompt, and helpful. Through our extension, we reduced our staff requirements and significantly improved our revenue stream.
I look back over the past five years of our relationship, and I can predict what the coming five years would look like. I can see immense growth opportunities for both of our organizations with the partnership that we have been able to develop. I absolutely recommend Pro Medical Billing Solutions.
What Sets Our Medical Billing and Coding Services Apart
Experience
857 Tristar, Suite A1,
Webster,
TX 77598, US.
2300 W Sahara Avenue, Suite 800,Las Vegas, NV 89102, US.
1600 Broadway, Suite 1600, Denver, CO 80202, US.
732 S 6TH ST, STE R, LAS VEGAS NV 89101, US.
5600 General Washington Dr Ste B207, Alexandria, VA, 22312, US.
Thousands of providers growing their practice with PROMBS.