Medicare has very specific requirements for preventive services. What can you bill, what must you document? This article covers all the bases … [Read more...]
Articles
Spotlight on up-to-date coding
Coding Multiple Procedures | Examples with Modifiers
Biopsies and lesion destruction codes are often performed at the same patient visit. This leads to questions about bundling and modifiers. There are … [Read more...]
Interprofessional Internet Consultations
CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 These codes were updated in 2023. Codes 99446, … [Read more...]
E/M Frequency Data for Dermatology
For dermatologists, revenue in the office is generated by procedures and office visits. Often, both are provided on the same day. See the dermatology … [Read more...]
E/M Frequency Data for Surgical Specialties
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. Unfortunately, there … [Read more...]
E/M Frequency Data for Psychiatrists
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. This is the data for … [Read more...]
E/M Frequency Data for Infectious Disease, Pulmonary Medicine and Cardiology
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. Infectious disease, … [Read more...]
Multiple E/M Services in the Same Calendar Day
The AMA has added a new subsection in the 2024 E/M section addressing how to report E/M services when there are multiple encounters in the same day. … [Read more...]
Psychiatric Collaborative Care Management Services
Psychiatric Collaborative Care Management Services 99492, 99493, 99494 Care Management for Behavioral Health 99484 PCCM quick reference … [Read more...]
Teaching Physician – Primary Care Exception
CMS updated the teaching physician rules in 2019, and this article reflects the change. On April 26, 2019 CMS released Transmittal 4283. The … [Read more...]
Two Visits for the Price of One? | Multiple Medical Visits on the Same Day
Patients often schedule two medical appointments on the same day with physicians of different specialties. It’s convenient for them. It saves travel … [Read more...]
How Fees are Set in the Medicare Fee Schedule
How does Medicare set its fees? This is important for other payers because commercial payers often use the values set by Medicare to calculate their … [Read more...]
What is a Coverage Policy?
National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) are Medicare’s coverage policies that describe medical necessity for … [Read more...]
Compliance Issues in ICD-10 Coding for Risk Based Contracts and HCCs
Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here's an important excerpt. "Code all documented … [Read more...]
Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442
The US Preventive Services Task Force (USPSTF) recommends screening for alcohol misuse and behavioral interventions for individuals whose screening … [Read more...]
Coding for Hernia Repair
CPT® revised the codes and concepts used for coding for hernia repair. These are significant changes for surgical procedures that are used very … [Read more...]
Principal Care Management (PCM) Services – CPT codes 99426—99427
There are four principal care management codes 99424 and 99425 are for time spent by a physician or other qualified health care professional … [Read more...]
Chronic Care Management
Medicare and private payers cover chronic care management services if a patient has two or more serious conditions that are expected to last at least … [Read more...]
Transitional Care Management
This article provides answers to frequently asked questions related to transitional care management services. It includes details about billing for … [Read more...]
Critical Care Services
Definition and Explanation of Critical Care Service Definition: Caring for a critically ill or injured patient Explanation: Critical care … [Read more...]
Nursing Facility Visits
Definition Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing … [Read more...]
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