Medicare pays a primary care physician or other primary care practitioner in a primary care setting to annually provide one face-to-face behavioral … [Read more...]
Articles
Spotlight on up-to-date coding
Screening for depression | HCPCS code G0444
G0444 Annual depression screening , 5—15 minutes Medicare pays primary care practices to screen all Medicare patients annually for depression. The … [Read more...]
Smoking cessation coding, 99406 and 99407
Medicare and most private insurers pay for physicians, NPs and PAs to counsel patients regarding smoking cessation. Medicare waives the … [Read more...]
Behavioral counseling for obesity, HCPCS code G0447
G0447 face-to-face behavioral counseling for obesity, 15 minutes G0473 Face-to-face hehavioral counseling for obesity, group (2-10) 30 … [Read more...]
Emergency Department Visits
Definition Emergency department (ED) services are E/M services provided to patients in the Emergency Department. Explanation These services … [Read more...]
Commonly Performed Procedures in Primary Care
These reference sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick … [Read more...]
Advance Care Planning | CPT® 99497, 99498
Advance Care Planning (ACP) 99497 Advance care planning including the explanation and discussion of advance directives such as standard forms (with … [Read more...]
Exam | Documentation Guidelines for E/M Services
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong....) However, we will still need to use them when auditing … [Read more...]
Using Time to Select a level of E/M service
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong....) However we will still need to use them when auditing … [Read more...]
Wellness visits and care management in Rural Health Centers and Federally Qualified Health Centers (RHCs and FQHCs)
RHCs and FQHCs are paid an all-inclusive rate (AIR) or national prospective payment system (PPS) rate for any service that is defined as a visit to … [Read more...]
Diabetes coding in Hierarchical Condition Coding (HCC)
Diabetes is a common chronic condition, included in three distinct HCC categories Patients often have more than one chronic condition of the … [Read more...]
Depression coding and Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, … [Read more...]
HCC coding: round up of chronic conditions
I saw on twitter recently that COPD was the third leading cause of death in the U.S. If it was on twitter, it must be true, right? This article … [Read more...]
Don’t forget Care Plan Oversight
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182) The requirements for each are different, … [Read more...]
Billing medical practice services for patients on hospice
Overview of hospice care Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their … [Read more...]
Prolonged services codes for Medicare preventive medicine services: G0513, G0514
There are HCPCS prolonged services codes to be used with Medicare preventive services reported based on time. CMS allows these prolonged care codes … [Read more...]
Dear Resident, Do you Understand Relative Value Units (RVUs)?
Measuring physician productivity with work RVUs: News flash! Physicians are more interested in medicine than coding. No doctor undertook the … [Read more...]
CPT® coding changes
2023 For a summary of this year's CPT® coding changes download the handout and watch the webinar here. We provide a review of CPT® and CMS changes … [Read more...]
Risk Coding for Medical Practices and Outpatient Services
Introduction to Risk Coding for Medical Practices and Outpatient Services Where do we find the rules for assigning diagnosis codes in medical … [Read more...]
CPT® code 99483: Cognitive assessment and care plan services
Developed in 2018, this service describes an in-depth assessment and development of care plan services for new or established patients who have signs … [Read more...]
Selecting CPT® rules for excision of skin lesions
Many medical practices perform skin procedures. A patient may see a dermatologist, a family physician or a surgeon when the time comes to find out, … [Read more...]