Medicare stunned us by creating two prolonged services HCPCS codes for use with Medicare covered preventive medicine services in 2018. They may be used only with Medicare covered preventive services when the typical intraservice time for the preventive service is met, and half of the prolonged care time. CMS then released the intraservice time for […]
Archives for February 2018
Medical Necessity Isn’t Medical Decision Making
Have you heard of Talk Ten Tuesdays? It’s an internet radio program hosted by Chuck Buck and Dr. Erica Remer, and every week they discuss current coding issues. They started with the implementation of ICD-10 and just kept going. I was a guest recently and discussed one of my pet peeves: equating medical necessity with […]
Can Two Practices Split the Post-Op Office Care of a Patient?
Question: Can two practices split the post-op office care of a patient? Answer: No. Although the operative and post-operative portions of the global package may be split between two groups, there isn’t any way to split the office post-op visits between two practices. CMS developed a single payment for global surgery that includes certain pre-op […]
Prolonged Services Codes for Medicare Preventive Medicine Services: G0513, G0514
Did you (or your clinician) ever have a wellness visit that took a really, truly, madly long time? And wondered what—if anything—you could bill with it? Wonder no more.
OB Coder Survey | Billing Extra Visits During Pregnancy
Thank you to the 63 generous coders and billers who answered my questions about billing extra OB visits during the maternity period. If we and our payers are following CPT® rules, these extra visits caring for a pregnant patient are separately billable. The editorial comments at the start of the Maternity Care and Delivery section […]