Navigating the AI Revolution in Gastroenterology
The integration of Artificial Intelligence (AI) in medicine has been expanding at an exponential pace. While not fully understood, AI has the potential to reshape our daily practice. At the ASGE 2026 GI Reimbursement and Coding Course on November 15, Glenn Littenberg, MD, MASGE presented on the current state and future promise of AI in documentation, coding, and compliance, offering a perspective of cautious optimism for the modern gastroenterologist.
The Double-Edged Sword: AI in Coding and Revenue Cycle Management (RCM)
In theory, AI can read and analyze clinical notes, select the appropriate CPT and diagnosis codes, apply complex rules regarding modifiers and sequencing, and transmit a clean claim. This could significantly enhance coding accuracy, reduce denials, and accelerate reimbursement.
Yet, this promise comes with significant risks. As practices adopt AI for revenue cycle management, payers are deploying their own AI systems to audit and downcode claims, creating an “arms race” that raises compliance and liability concerns. If an AI-driven coding error leads to an audit or fraud accusation, who is responsible – the physician, the practice, or the vendor?
As practices consider these tools, a thorough cost-benefit analysis and a clear understanding of liability are essential.
Risks and Realities: A Call for Due Diligence
While the potential of AI is immense, it is a rapidly evolving technology still prone to errors and unintended consequences. Generative AI models can “hallucinate” and create false information, and without proper safeguards, they can even be manipulated to provide harmful or dangerous advice. This underscores the absolute necessity of human oversight in any clinical or administrative implementation.
When evaluating AI products, one must ask:
- Who trained this AI and based on what materials?
- Who owns the data that the practice uploads to the cloud?
- Who truly profits from this technology?
- Will use of the AI product genuinely lead to administrative relief or will it just create new, different kinds of work?
The regulatory landscape governing AI is also in flux with one administration aiming to establish federal safety and equity standards and another promoting deregulation to spur innovation. This uncertainty means that the guardrails for AI in healthcare are still being built, making early adoption a venture that requires careful navigation.
Moving Forward with Purpose and Caution
The use of AI in GI offers the promise of alleviating administrative burdens and streamlining the revenue cycle. However, this promise is coupled with significant challenges related to cost, EHR integration, compliance liability, and an escalating technological race with payers.
For fellows and attending physicians, the path forward is to engage with AI critically and thoughtfully and advocate for sensible regulations that protect patients and support the well-being of providers.
Authors
Amulya Reddy, DO, practices at Northwestern Medical Group and specializes in digestive tract disorders. Dr. Reddy serves on the ASGE Reimbursement Committee and was a 2025 participant in the Leadership Education and Development (LEAD) program.
Edward Sun, MD, MBA, FASGE, is Associate Medical Director at Peconic Bay Medical Center. Dr. Sun serves as Chair of the ASGE Reimbursement Committee.