Gastroenterology Billing Services

Billing that fits a
gastroenterology practice

It starts with one question: was this a screening, a surveillance exam, or a diagnostic one? The answer sets the code and decides what the patient owes. Get it wrong, and you lose the payment, or you bill someone who was promised a free visit. Our gastroenterology billing services get that call right the first time.

96%avg. net collection rate across TruCare clients

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TruCare by the numbers

96%

average net collection rate across TruCare clients

>95%

clean claim rate, accepted on first submission

−37%

fewer claim rejections

−38%

days in A/R

Figures reflect TruCare client results and are not specific to gastroenterology.

Why practices choose gastroenterology medical billing servicesfrom TruCare

4.8

Based on 180+ client reviews

Verified client reviews

Apr 02, 2026

The complaint calls stopped

Patients kept ringing the front desk about bills for screenings we told them were free. TruCare found the modifier was missing on almost every converted case. That problem is gone.

Carla Jessup, practice administrator

3 weeks ago

Both claims go out together

We own our endoscopy center, and the facility side was always a day or two behind. Now the two claims leave together, and I am not reconciling them by hand.

B. Trujillo, endoscopy center manager

Feb 11, 2026

Somebody reads the op note

Our last company coded from the schedule. If the case said screening, they billed screening, even when I took out three polyps. TruCare reads what I actually wrote.

Dr. Neil Abrahams, managing partner

Jan 22, 2026

Path charges stopped vanishing

Specimens were going to the lab and never reaching a claim. They caught it in the first month and built a daily check against our schedule.

Hannah Oyelaran, patient accounts lead

Dec 09, 2025

Two new physicians, no slowdown

We brought on two associates last year. Their enrollments were completed before their first clinic day, which had never happened for us before.

Dr. Grace Lim, gastroenterologist

What we take care of

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We get your physicians enrolled

TruCred files Medicare and commercial enrollments and keeps your provider records current. Add a physician, an NP, or an endoscopy center, and we get them on the plans. We track revalidation dates so nobody drops off mid-year.

Medicare enrollmentPECOS upkeepRevalidation

One procedure. Four ways to bill it.

A patient comes in for a colonoscopy. If they have no symptoms and are due, it is a screening. If they had polyps before, it is surveillance. If they have symptoms, it is diagnostic. And if the exam starts as a screening and a polyp comes out, it becomes something else again while the patient is still on the table.

Each of those is a different code. Two of them need a modifier. All of them change what the patient owes. Under Medicare, a screening with nothing found costs the patient nothing. A screening where a polyp is removed waives the deductible but still applies coinsurance.

This is why general billing companies struggle with gastroenterology. The claim looks simple. The decision behind it is not, and it is made in the endoscopy suite, not in the billing office. Our billers read the operative note before they pick the code, because in GI that is where the answer lives.

Six places a gastroenterology claim goes wrong

The modifier was left off

When a screening turns into a polyp removal, Medicare needs modifier PT, and most commercial plans need modifier 33. Without it, the claim reads as fully diagnostic, and the patient gets billed for something they were told was covered.

The wrong screening code was used

Medicare uses G0105 for high-risk patients and G0121 for average-risk patients. Commercial plans mostly use the CPT code with modifier 33. Mixing the two sets is a routine denial.

The patient was not actually due

Medicare pays for screening colonoscopy on a set schedule. Book it early, and the claim is denied for frequency. We check the last exam date before the appointment, not after.

The facility side never went out

If you own the endoscopy center, every case has two claims. Practices that focus on the physician side leave the larger one sitting.

Pathology and anesthesia were forgotten, or coded wrong

Specimens and sedation are billable work, and in busy practices they are the easiest lines to lose. Anesthesia has its own conversion rule too: when a screening becomes diagnostic, Medicare wants a different anesthesia code with the PT modifier on it.

The codes bundled against each other

Multiple procedures in one session follow strict bundling rules. Bill them incorrectly and the whole claim reprocesses at a lower rate or denied.

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Our service offerings

Every service your practice performs, billed correctly

Colonoscopy

Screening, surveillance, and diagnostic exams, including biopsy, polypectomy, and ablation. The highest-volume service in most practices and the one with the most ways to get it wrong.

Upper endoscopy

EGD with biopsy, dilation, bleeding control, and ablation. Coded to what was done, not to what was scheduled.

ERCP and endoscopic ultrasound

Advanced procedures have their own bundling rules and their own documentation requirements. Often the highest-value cases on your schedule.

Capsule endoscopy

Studies show that many plans require approval in advance. We check the requirements before the capsule is swallowed.

Motility and reflux testing

Esophageal manometry, pH and impedance studies, breath testing, and the anorectal codes that changed in 2026.

Bariatric endoscopy

Endoscopic sleeve gastroplasty now has its own permanent code with a 90-day global period. Follow-up visits within that window cannot be billed separately.

Infusion for IBD

Biologic therapy is billed with the drug, the administration, and any waste documented. Prior authorization is handled before the chair is booked.

Office visits and chronic care

New and established visits for IBD, liver disease, and reflux are billed at the level the documentation supports.

What you get with TruCare

Billers who read operative notes

Your claims are handled by certified billers and coders who work on gastroenterology procedures. They check the indication against the findings before choosing a code, because in GI those two things decide the claim.

No new software to learn

We work on top of the system your practice already uses. Epic, Athenahealth, eClinicalWorks, AdvancedMD, Elation, and others. No migration, no second login for your staff.

New physicians billing sooner

Recruiting a gastroenterologist is hard enough without waiting months to bill for them. TruCred starts the enrollments as soon as the contract is signed.

The denials we see most in gastroenterology, and how we stop them

Gastroenterology denials follow a short and predictable list. Most of them start before the claim is built, in how the procedure was booked and how the note was written.

Each one has a fix that belongs upstream, at scheduling or in the note, not in a resubmission. That is where we put it.

Not sure where your denials are coming from?

We will review your last 90 days and show you the pattern.

Request a billing audit

Here is what we catch first:

Modifier missing on a converted screening

The most common and most fixable GI error. A screening that becomes a polypectomy needs PT for Medicare or 33 for most commercial plans.

Screening billed as diagnostic, or the reverse

If the patient had symptoms, it is diagnostic. If they did not, it is screening. Billing one as the other affects both payment and what the patient owes.

Frequency limits

Screening colonoscopy is covered on a schedule. A patient who is not yet due is denied, and the practice usually finds out weeks later.

Bundled procedures in one session

Multiple procedures through the same scope follow specific rules about what can be billed together and when a distinct-site modifier is appropriate.

Incomplete or aborted procedures

A colonoscopy stopped for poor prep or patient safety has its own reporting rules. Billing it as complete invites a denial and an audit question.

Missing prior authorization

Capsule studies, infusions, and some advanced procedures need approval first, with many plans. We check the requirements before the date is booked.

The codes behind your revenue

Gastroenterology runs on a small group of codes used thousands of times a year. A small error repeated across a full schedule becomes a large number by December.

Our coders work GI charts every day. They know which codes cannot be billed together, which ones need a modifier, and which ones changed this year.

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TruCare's coding coverage includes:

45378 to 45398

Colonoscopy

The base diagnostic exam, plus biopsy, snare polypectomy, ablation, and mucosal resection. The code follows what was done during the exam.

We work in your system and catch what gets missed

Nothing about your schedule changes. TruCare connects to Epic, athenahealth, eClinicalWorks, AdvancedMD, Elation, and the other systems practices use, so visits, notes, and procedure details come across on their own. No migration weekend. No second login for your endoscopy staff.

The difference shows up in what does not slip. A converted screening missing its modifier. A patient booked before they are due. A specimen sent to the lab with no charge behind it. An appeal with a deadline this week. Those surface on a worklist instead of in next month’s denial report.

See a demo with your EHR

Deep integrations with all EHRs

TruCare connects seamlessly with your existing workflows — no switching required.

What changed for gastroenterology in 2026

Endoscopic sleeve gastroplasty got its own code

ESG moved from an unlisted code to a permanent CPT code on January 1, 2026. It carries a 90-day global period, so follow-up visits in that window are included in the payment and cannot be billed separately.

Anorectal testing was rebuilt

Two new codes replaced the older anorectal manometry codes, which were deleted. Practices still billing the retired codes will see rejections.

A new code for percutaneous nerve field stimulation

The GI societies confirmed a new Category I code for PENFS, which moves it out of temporary code territory.

Colon motility testing was updated

The 2026 code set revised how these studies are reported, as part of a broader modernization that the GI societies worked through with the AMA.

Patient cost-share on converted screenings is still stepping down

Under current law, Medicare waives the deductible and applies 15 percent coinsurance through 2026. That drops to 10 percent for 2027 through 2029 and to zero in 2030.

Fee schedule values moved

The 2026 fee schedule reduced the work value of most codes that are not billed by time. Endoscopy codes are in that group, and a GI practice bills them all day.

How we keep rule changes from costing you

Code sets change every January, and payer policies change whenever they like. Following both is part of what you are paying us for.

A deleted code or a shifted cost-share rule gets built into our checks before your first claim of the year goes out.

We also read the remittance rather than just posting it. If a payer pays below your contracted rate, that is a conversation we start, not a difference you absorb.

In-house vs. outsourced

Should you keep billing in-house?

An in-house biller knows your physicians and your patients. Outsourcing gastroenterology billing services brings people who see the same denials across many practices. Both approaches work. Both have a cost that shows up somewhere.

Here is what actually differs:

The question	In-house billing	With TruCare
Screening versus diagnostic calls	One person’s judgment, case by case	Coders who check the indication against the findings every time
Modifier accuracy	Easy to miss on a busy schedule	Checked on every converted screening before submission
Frequency checks	Done when there is time	Run before the appointment is confirmed
Facility claims	Often a second job nobody owns	Billed alongside the professional claim
Pathology and anesthesia	Slip through in busy weeks	Reconciled against the day’s schedule
Code changes	Read about later	Built into claim edits when they take effect
Records requests	Land on whoever is free	Assembled and filed before the deadline
Cost shape	Salary, benefits, training, software	A percentage of collections, so it scales with your schedule
Absence and turnover	A resignation in March is felt through June	Staffing the desk is on us, not on your office manager
What the owner sees	A report someone builds on request	Denials by reason and revenue by physician, live

Curious where your practice lands?Send us 90 days of denials, and we will show you what is fixable.

Hover a state to see coverage

Where we serve

We bill gastroenterology in every state

We work with single-physician practices, multi-site GI groups, physician-owned endoscopy centers, hepatology practices, and motility labs. Coverage rules differ by state and by Medicare contractor, so we handle them one plan at a time.

Multi-state enrollment

ASC and professional billing

Prior authorization

Clearinghouse connections

Denial and appeal management

A named account contact

Who we bill every day

Medicare Part B

Screening rules, frequency limits, and contractor coverage policies

Medicare Advantage

Plan-by-plan authorization rules

Medicaid and managed Medicaid

State programs and MCO plans

BCBS and Anthem

Preventive coverage that varies by plan

Centene family

Molina, WellCare, Amerigroup

Other

Workers’ compensation, VA Community Care, self-pay

We bill whatever plans your practice is contracted with. If you are not contracted yet, TruCred handles the enrollment.

Gastroenterology billing saver guide

A practice collecting $1.1 million saves up to$45,670 a year by outsourcing to TruCare

	In-house billing	With TruCare	Annual saving
Dedicated billing staff	$73,060	$0	$73,060
Billing software and clearinghouse	Varies	Included	—
Training, turnover, and coverage	Varies	Included	—
TruCare fee (from 2.49% of collections)	—	$27,390	—
Total annual cost	$73,060	$27,390	$45,670

Example: a practice collecting $1.1 million a year with one full-time biller, at TruCare’s starting rate of 2.49%. Biller cost uses the BLS May 2025 median wage for medical records specialists ($51,140), with benefits at 30% of total compensation. Software and training costs vary by practice and are not counted. We do not replace your front desk; we take the claims work off it. Larger groups are quoted on volume rather than at the starting rate, so a bigger practice should not scale this example up.

Want this run on your own numbers?

Talk to a gastroenterology billing expert

What practices notice first

““We had been with the same billing company for nine years. Nobody there could tell me why a screening became a diagnostic claim, or who decided that. TruCare walked us through a week of our own cases and showed us where the money was going. The fix was mostly in how we classify the case up front, and they handled it.””

Dr. Rachel Okonjo

managing partner, Riverbend Digestive Health

Billing that fits a gastroenterology practice