Common rules: Prolonged services codes are add-on codes to E/M services. In order to use prolonged care, the primary code must be selected … [Read more...]
Articles
Spotlight on up-to-date coding
Outpatient Diabetes Self-Management Training (DSMT) Services
Diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an … [Read more...]
Coding for Medical Nutrition Therapy Services
Medical Nutrition Therapy Services (MNT) have been a covered benefit under Medicare since the early 2000’s. This article will describe the rules … [Read more...]
Coding and Reimbursement for Lactation Services
Questions about coverage and payment for breastfeeding and lactation counseling services come up regularly. And, payers change their policies. It is … [Read more...]
When to Use Time to Select an E/M Service
Selecting a code for an E/M service can be done based on time or MDM (except ED visits which only use MDM) Time includes all time spent by the … [Read more...]
Office Visit Code Selection for Medication Management
At some visits, psychiatrists and psychiatric NPs and PAs provide only medication management, and at some visits, they manage prescriptions and … [Read more...]
HCC Diagnosis Coding Example: Diabetes, Hypertension, Chronic Kidney Disease
If a picture is worth 1000 words, what’s an example worth? An example can show in a glance what it takes paragraphs to write and explain. The one … [Read more...]
Essential Documentation for Medication Management and Psychotherapy
When providing both medication management and psychotherapy, practitioners need to document the time spent in psychotherapy and describe the therapy. … [Read more...]
Behavioral Health and Telemedicine During the PHE
In this post Overview of behavioral health services via telemedicine during the PHE Overview of behavioral health services after the PHE … [Read more...]
Is it or isn’t it a Telehealth Service?
Many payers and practices use the broad term telehealth to describe services that are not done face-to-face with a patient CMs describes telehealth … [Read more...]
Specimen Collection For COVID-19
CMS’s 4/30/2020 rule states that practices could bill 99211 for new or established patients during the public health emergency for COVID-19 specimen … [Read more...]
Medicare Changes Telehealth Rules, Again
Medicare changes telehealth rules, again: April 30, 2020 interim final rule with comment period … [Read more...]
Telemedicine in RHCs and FQHCs
In April, 2020Â CMS released guidance about paying for telehealth services in Rural Health Centers (RHCs) and Federally Qualified Health Centers … [Read more...]
Consent for Communication Technology-Based Services (CTBS)
Both CPT and CMS have developed codes for non-face-to-face communication-based technology services in recent years. In addition to care management … [Read more...]
Blood Pressure Self-Measurement: Education, Training and Analysis | CPT Codes 99473, 99474
There are two CPT codes specifically for blood pressure self-measurement and management. The first is for patient education and calibration of a home … [Read more...]
The First Element of MDM: Number and Complexity of Problems Addressed
E/M elements for MDM There are three elements in medical decision-making and this article describes the first of three When selecting a level … [Read more...]
The Third Element of MDM: Risk of Complications
The third element of MDM: risk of complications and/or morbidity or mortality of patient management at the encounter Coding for E/M services … [Read more...]
The Second Element of MDM: Amount and/or Complexity of Data
There are three elements in medical decision-making and this article describes the second, arguably, the most complex of the three elements When … [Read more...]
E/M Services – History and Exam
History and exam for E/M services “E/M Codes that have levels of services include a medically appropriate history and/or physical examination when … [Read more...]
Procedure Coding for Colonoscopies
“A colonoscopy is the examination of the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum or small … [Read more...]
Overview of Diagnosis Coding for Behavioral Health Services
Match diagnoses on the claim form to those listed in assessment The diagnosis codes on the claim form should match those in the note. If the … [Read more...]