AI Scribe for Gastroenterologists
Screening colonoscopies, EGDs with biopsy, IBD follow-ups, and hepatology consults — documented in seconds. PatientNotes captures Paris classification, Boston Bowel Prep scores, withdrawal time, MELD-Na, and IBD activity indices, then maps them to the right CPT and ICD-10 codes.
Documentation for Every Gastroenterology Visit
From a 10-minute screening colonoscopy to a complex cirrhotic with varices, PatientNotes uses the right structure for the case.
Screening & Surveillance Colonoscopy
Boston Bowel Prep score by segment, cecal intubation time, withdrawal time, polyp count and Paris classification, snare/cold-forceps technique, and surveillance interval per USMSTF guidelines.
EGD with Biopsy
Esophagus to second portion of duodenum: Z-line, Prague C&M for Barrett, Los Angeles grade for esophagitis, Forrest classification for ulcers, and biopsy site mapping.
IBD Management
Crohn and ulcerative colitis follow-up with Harvey-Bradshaw / partial Mayo scoring, biologic dosing, fecal calprotectin and CRP trends, and TPMT/NUDT15 monitoring.
Hepatology (NAFLD / Cirrhosis)
NAFLD/MASH workup, FIB-4 and APRI calculation, FibroScan kPa and CAP, MELD-Na and Child-Pugh, varices surveillance, and HCC screening with abdominal US/AFP.
Functional GI
IBS subtype (IBS-C, IBS-D, IBS-M), Rome IV criteria, gastroparesis evaluation with gastric emptying study, and dyspepsia workup with H. pylori testing.
GI Bleeding Evaluation
Upper vs lower vs obscure GI bleed workup, Glasgow-Blatchford score, transfusion thresholds, hemostasis technique (clip, thermal, injection), and post-procedure plan.
Gastroenterology-Specific Features
Built around the language a working endoscopist actually uses — not generic medical English.
Paris Classification & BBPS
Captures polyp morphology (0-Ip pedunculated, 0-Is sessile, 0-IIa/b/c flat) and the Boston Bowel Prep Scale by segment (right colon, transverse, left colon), with the total 0-9 score that ASC quality programs report.
Withdrawal Time & ADR
Documents cecal intubation time and withdrawal time so your ADR (adenoma detection rate) and PDR (polyp detection rate) quality metrics report cleanly to the GIQuIC registry.
IBD Activity Indices
Calculates Harvey-Bradshaw Index for Crohn disease and partial Mayo / Mayo for ulcerative colitis, with biologic trough levels (infliximab, adalimumab) and antibody status if relevant.
Hepatology Scoring
Auto-calculates MELD-Na, Child-Pugh class A/B/C, FIB-4, and APRI from labs you have already documented. Pulls FibroScan kPa and CAP into the assessment for NAFLD/MASH staging.
Procedure Report Templates
Pre-built colonoscopy and EGD reports that match the structure ASCs and pathologists expect: indication, sedation, prep, anatomic findings by segment, interventions, complications, and post-procedure plan.
CPT 45378 / 45380 / 45385 / 43239
Suggests the right colonoscopy code (45378 diagnostic, 45380 with biopsy, 45385 with snare polypectomy, 45384 hot biopsy/ablation), the right EGD code (43235, 43239), and the E&M level for clinic visits.
A real day in clinic and the ASC, before and after
A typical outpatient gastroenterologist runs an endoscopy block of 12-20 cases on procedure days and a clinic of 18-25 patients on office days. The block list bleeds into the late afternoon when reports are dictated between cases, and clinic notes — IBD follow-ups with biologic levels, cirrhotics with varices, IBS workups under Rome IV — pile up after hours. The work that drives the late-night charting is rarely the medicine. It is the procedure reports for Provation or gMed, the consult letters back to the surgeons and PCPs, and the prior authorization notes for biologics and SGLT2 inhibitors used off-label in NAFLD.
With PatientNotes running in the background during the visit (or as the procedure narration to the endoscopy tech), the patient sees the same encounter. You inspect the cecum, photo-document the appendiceal orifice, narrate the polyp size and Paris morphology, and call out the snare technique. The narration is the documentation. By the time the patient is in recovery, the structured procedure report — Boston Bowel Prep score by segment, intubation and withdrawal times, polyp findings with Paris classification, and suggested CPT 45385 + modifier 33 for screening converted to therapeutic — is drafted and waiting for your signature.
The model is tuned for GI. It knows that "BBPS 3-3-3" means excellent prep, that "0-Is at hepatic flexure, removed with cold snare" needs to land in both the findings and the intervention section, and that a Forrest IIa ulcer changes the post-procedure plan. Notes are typically ready 30-90 seconds after the encounter ends, which is fast enough to review before the next case is wheeled in.
Sample AI-Generated Colonoscopy Report
An actual surveillance colonoscopy with mixed polypectomy the model would produce. Real prep score, real Paris classification, real CPT mapping.
COLONOSCOPY PROCEDURE REPORT
Date: 04/22/2026 | CPT: 45385 (colonoscopy with snare polypectomy) + 45380 (with biopsy)
PATIENT: 62-year-old male
INDICATION: Surveillance colonoscopy 5 years after removal of two tubular adenomas.
Average risk otherwise. Last screening exam 2021.
CONSENT: Informed consent obtained — risks of bleeding (~1%), perforation (<0.1%),
sedation, and missed lesions discussed and documented.
SEDATION: MAC anesthesia by CRNA. Propofol per anesthesia protocol. Tolerated well,
no events. Discharge criteria met at 35 minutes post-procedure.
PREP QUALITY (Boston Bowel Prep Scale):
Right colon: 3 Transverse: 3 Left colon: 3 Total: 9/9 (excellent)
PROCEDURE:
Olympus CF-HQ190L colonoscope introduced through anus. Advanced through rectum,
sigmoid, descending, transverse, and ascending colon to cecum.
Cecum identified by appendiceal orifice and ileocecal valve. Photo-documented.
Terminal ileum intubated for 8 cm — normal villous pattern, no ulcers.
Cecal intubation time: 7 minutes
Withdrawal time: 14 minutes (excludes time spent on polypectomy)
Total procedure time: 28 minutes
FINDINGS BY SEGMENT:
Terminal Ileum: Normal mucosa. No erosions, ulcers, or strictures. Biopsy not taken.
Cecum / Ascending Colon:
- 6 mm sessile polyp at hepatic flexure
- Paris classification: 0-Is
- Removed en bloc with cold snare polypectomy
- Adequate hemostasis confirmed; no clips required
- Specimen retrieved and sent in formalin: "polyp, hepatic flexure"
Transverse Colon:
- 12 mm sessile serrated lesion at mid-transverse colon
- Paris classification: 0-IIa (flat elevated), with mucus cap
- Submucosal injection with saline + indigo carmine for lift
- Removed in 2 pieces with hot snare (piecemeal EMR)
- Defect closed with 3 endoclips
- Specimen retrieved: "polyp, mid-transverse colon, piecemeal"
Splenic Flexure / Descending Colon: Normal. No polyps, no ulcerations.
Sigmoid Colon:
- Moderate diverticulosis without inflammation or stigmata of recent bleed
- 4 mm sessile polyp in proximal sigmoid
- Paris classification: 0-Is
- Removed with cold forceps
- Specimen retrieved: "polyp, sigmoid colon"
Rectum: Normal. Internal hemorrhoids on retroflexion (Grade 1, non-bleeding).
INTERVENTIONS:
1. Cold snare polypectomy x1 (hepatic flexure, 6 mm)
2. Hot snare piecemeal EMR x1 (mid-transverse, 12 mm SSL) with 3 endoclips
3. Cold forceps polypectomy x1 (sigmoid, 4 mm)
COMPLICATIONS: None. Hemodynamically stable throughout. No abdominal distention.
ASSESSMENT & PLAN:
1. Three colon polyps removed; two adenomas suspected on visual inspection
plus one likely sessile serrated lesion. Awaiting pathology (5-7 days).
2. Surveillance interval will be guided by histology per USMSTF 2020 guidelines
— anticipate 3-year repeat if SSL >=10 mm or any high-grade dysplasia,
otherwise 5 years.
3. Diverticulosis without bleeding — high-fiber diet counseling reinforced.
4. Patient discharged home with adult driver. Standard return precautions:
severe abdominal pain, hematochezia >small streaks, fever >38.5C, syncope.
5. Will call patient with pathology and surveillance recommendation in 7-10 days.
Letter to PCP (Dr. Lewis) drafted.
Suggested ICD-10: Z12.11 (encounter for screening for malignant neoplasm of colon),
Z86.010 (personal history of colonic polyps), K57.30 (diverticulosis),
K64.0 (Grade 1 internal hemorrhoids).
Suggested CPT: 45385 (colonoscopy w/ snare polypectomy), 45380 (w/ biopsy add-on),
modifier 33 if billed as screening converted to therapeutic.Intelligent ICD-10 Suggestions
The codes most GI practices bill on a daily basis — surfaced from the documentation, not guessed.
K57.30Diverticulosis of large intestine without perforation/abscess/bleedingK50.90Crohn disease, unspecified, without complicationsK51.90Ulcerative colitis, unspecified, without complicationsK21.9Gastroesophageal reflux disease without esophagitisK22.70Barrett esophagus without dysplasiaK76.0Fatty (change of) liver — NAFLD/MASHK74.60Cirrhosis of liver, unspecifiedK63.5Polyp of colonThe AI suggests relevant codes based on what you actually documented. You review and confirm — there is no auto-billing.
Gastroenterologists using PatientNotes today
Three composite stories drawn from real onboarding interviews. Names changed, details preserved.
Dr. Daniel Park
Solo gastroenterologist, Sacramento CA — clinic 2 days, ASC 3 days
Daniel runs his own ASC half-room two days a week and was finishing procedure reports between cases on his phone, which slowed his block list. He started recording the procedure narration into PatientNotes during the case and now has the structured report ready before the patient leaves recovery. He uses the colonoscopy template most, edits a sentence or two per case, and pastes into Provation. The $50/month price was inside his MA budget — no partner approval needed.
Dr. Priya Iyer
Mid-size GI group, 9 gastroenterologists + 1 hepatologist, Charlotte NC
Priya's group had a Nuance DAX demo and was quoted around $4,200 per clinician per year on a 24-month contract. They piloted PatientNotes for 60 days first and the group voted to switch. They customized one shared IBD template that puts biologic dose, last infusion date, and most recent CRP/calprotectin in the assessment, which made handoff between partners faster. The hepatologist uses the cirrhosis follow-up template with auto-calculated MELD-Na.
Dr. Marcus O'Hara
Hospital-employed advanced endoscopist, large academic system, Cleveland OH
Marcus does ERCP and EUS three days a week at the academic medical center, plus one day of general endoscopy. The hospital had DAX rolled out for primary care but not for procedural specialties. He uses PatientNotes for his clinic day — new-patient pancreaticobiliary consults and ERCP follow-ups — and pastes the structured note into Epic. He estimates 75-90 minutes a day of saved charting and keeps using the hospital dictation system in the procedure room itself.
Coming from Microsoft Dragon Medical One?
Microsoft Dragon Medical One has been the dictation standard in gastroenterology for two decades — many endoscopists are very fast with it inside Provation or gMed. The newer Microsoft Dragon Copilot adds ambient capture on top of the Dragon engine. Both are real products, but the workflow is different from PatientNotes.
Dragon Medical One
- •Dictation: you talk to a microphone, the words appear in your endoscopy reporting system or EHR.
- •Mature voice profile — typically 99% accuracy after a few weeks of training.
- •$99-$200/month per clinician for Dragon Medical One; Dragon Copilot adds ambient at higher tiers ($250+).
- •Strong Epic / gMed / Provation integration via the Dragon plug-in.
- •You still author the structure of the procedure note; Dragon types it for you.
PatientNotes
- •Ambient: you talk to the patient (or narrate the procedure to the tech), the report writes itself.
- •No voice training. Works on day one.
- •$50/month flat — no per-encounter fees, no enterprise minimums.
- •No EHR/endoscopy-system integration required — copy/paste workflow, ready in hours.
- •Generates the procedure report structure (prep, anatomy, findings, interventions, plan) for you.
How to switch in three steps
Sign up and run a parallel day
For one full clinic or endoscopy day, record encounters in PatientNotes while still using Dragon as your primary. Compare the two procedure reports side by side at the end of the day.
Customize one GI template
Pick your highest-volume template (most GIs pick screening colonoscopy or EGD with biopsy) and tune the structure so the findings section is in the segment order you prefer.
Cancel Dragon when you are ready
Most gastroenterologists are off Dragon within 5-7 days. Keep it as a backup for the first month if you want — they do not conflict.
PatientNotes vs Nuance DAX
Nuance DAX (now part of Microsoft Dragon Copilot) is the enterprise AI scribe most often pitched to GI groups, especially those with hospital affiliations or shared ASC ownership. We have lost deals to DAX and we have won deals against DAX. Here is the honest read for gastroenterology.
| Feature | PatientNotes | Nuance DAX |
|---|---|---|
| Monthly price (per clinician) | $50 | $250-$400 |
| Setup time | Same day | 8-12 weeks (Epic App Orchard or Provation interface) |
| Contract | Month-to-month | Typically 12-24 month minimum |
| GI templates | Colonoscopy, EGD, IBD, hepatology, GI bleed, functional GI | Available, often custom-built per practice with paid implementation |
| Paris / BBPS / withdrawal time | Yes | Yes |
| Hepatology scoring (MELD, FIB-4) | Yes | Yes |
| Provation / gMed write-back | Copy/paste | Direct integration available |
| Best fit | Independent / group / freestanding ASC, 1-30 clinicians | Hospital-owned ASC already in Epic + DAX ecosystem |
If your hospital or health system has already paid for DAX and integrated it into Epic and your ASC reporting system, use that. The marginal benefit of switching is small. If you are independent, in a small/mid-size GI group, or running a freestanding endoscopy center, PatientNotes is almost always the right answer — the price difference alone funds an additional MA or covers your annual GIQuIC registry fees.
Frequently Asked Questions
Real questions from gastroenterology onboarding calls.
Does PatientNotes work for gastroenterology?
Yes. PatientNotes is used by general gastroenterologists, advanced endoscopists, IBD specialists, and hepatologists. The model is tuned for GI language, so it correctly captures Paris classification of polyps (0-Ip pedunculated, 0-Is sessile, 0-IIa flat elevated, 0-IIb flat, 0-IIc depressed), Boston Bowel Prep Scale (BBPS) by segment, withdrawal time, IBD activity indices (Harvey-Bradshaw for Crohn, partial Mayo for ulcerative colitis), and hepatology scoring (MELD-Na, Child-Pugh, FIB-4). It outputs structured procedure reports for colonoscopy and EGD, SOAP notes for clinic follow-up, and consult letters back to the referring PCP or surgeon.
How much does an AI scribe cost for gastroenterology?
PatientNotes is $50 per clinician per month, billed monthly with no per-encounter or per-procedure fees. Nuance DAX (now part of Microsoft Dragon Copilot) typically runs $250-$400 per clinician per month for procedure-heavy specialties like GI, often with a 12-month enterprise contract and an implementation fee in the $5,000-$15,000 range. For a gastroenterologist running two endoscopy lists and three clinic days per week, the difference is roughly $2,400-$4,200 per year per provider.
Is Nuance DAX better than PatientNotes for gastroenterology?
DAX is a mature enterprise product with deep Epic integration and an established procedural-note workflow that some ASCs (ambulatory surgery centers) have already invested in. PatientNotes is materially cheaper, deploys the same day, and produces equivalent-quality colonoscopy and EGD reports in the side-by-side reviews we run with practicing endoscopists. If your ASC is already paying for DAX through the hospital, use that. If you are independent, in a small/mid-size GI group, or running a freestanding endoscopy center, PatientNotes is almost always the better fit on price and time-to-value.
Can gastroenterology-specific notes be auto-generated?
Yes. PatientNotes ships with GI templates for screening colonoscopy, surveillance colonoscopy, EGD with biopsy, IBD follow-up, hepatology consult, GERD/Barrett surveillance, GI bleed evaluation, and functional GI (IBS, gastroparesis, dyspepsia). You can customize templates so the procedure note always lists prep quality first, intubation/withdrawal time second, and findings by anatomic segment, which is the format pathologists and ASC quality programs prefer.
Does it integrate with Epic, gMed, and Provation for gastroenterology?
PatientNotes works alongside Epic (including Epic Beaker for path), gMed, Provation MD, ProVation Apex, and athenahealth. The note is generated in PatientNotes and pasted or copied into your endoscopy reporting system or EHR using a one-click copy. We do not require a write-back integration, which is what lets us deploy in a day instead of the 8-12 weeks an Epic App Orchard or Provation interface project usually takes.
Will it help me bill gastroenterology CPT correctly?
PatientNotes suggests E&M codes (99213-99215) based on documented MDM (medical decision making) and surfaces commonly missed GI procedure codes such as 45378 (diagnostic colonoscopy), 45380 (colonoscopy with biopsy), 45385 (colonoscopy with snare polypectomy), 45384 (colonoscopy with hot biopsy/ablation), 43235 (diagnostic EGD), 43239 (EGD with biopsy), 91110 (capsule endoscopy), and 76705 (limited abdominal ultrasound for HCC surveillance). It does not auto-bill — you review and confirm each code, which is the audit-defensible pattern.
How do I switch from Dragon Medical One to PatientNotes?
Three steps. First, sign up at patientnotes.ai and complete the 5-minute clinician onboarding. Second, run PatientNotes in parallel with Dragon for one full clinic or endoscopy day — record the encounter in PatientNotes, then dictate with Dragon as you normally would. Compare the notes side by side. Third, when ready, retire Dragon. Most gastroenterologists make the switch in under a week. Dragon is dictation; PatientNotes is ambient — the conversation with the patient (or the procedural language you say to the tech) becomes the note automatically.
Is it HIPAA compliant for gastroenterology?
Yes. PatientNotes is HIPAA compliant, signs a Business Associate Agreement (BAA) with every practice and ASC on request, and encrypts audio and notes at rest and in transit. Audio is processed and discarded — we do not retain recordings beyond the time needed to generate the note. Patient identifiers are minimized in the prompt sent to the language model. We do not train models on your data. ASCs that have completed a HIPAA security risk assessment have onboarded PatientNotes without a separate IT review in most cases.
Finish procedure reports before the next case is wheeled in.
Gastroenterologists on PatientNotes save 90 minutes to two hours of charting per day across clinic and the ASC — the difference between dinner with the family and signing reports at 10 PM.
No credit card required. $50/month after trial. Cancel anytime.