Download Guide Guide updated Sept. 2025 This guide addresses CPT® coding for maternity care services. It covers coding for professional services performed by physicians and other qualified health care professionals including Certified Nurse Midwives in obstetrics, family medicine, and maternal-fetal medicine. It describes how to code for global maternity care, antepartum care only, delivery services […]
Care Management Services | Webinar
Event date: October 30th, 2025
1 CEU expires 10/30/26
Guest presenter Pam Warren of MaineHealth
Care management services include Transitional Care Management, Chronic Care Management, Principal Care Management and Advanced Primary Care Management. Each type of care management has its own purpose and service requirements.
Reporting the Global Surgical Package | Webinar
Event date: October 16th, 2025
1 CEU expires 10/30/26
The global surgical package provides a single payment for services normally performed before, during and after a procedure. This webinar will review both CPT® and CMS rules and explain what services are included in the payment and what services may be reported separately.
ICD-10-CM Update | Webinar
Event date: September 25th, 2025
1 CEU expires 9/30/26
Guest Presenter Shannon McCall of HCPro
ICD-10-CM updates are here and effective starting October 1, 2025. This webinar will describe changes to the all-important ICD-10-CM Official Guidelines for Coding and Reporting.
Selecting the Correct Place of Service Code
Pam Warren, MHA, COC, CPC, Fellow We’ve all seen that two-page chart in the CPT® book that indicates the place of service code (POS) that is expected to be reported for physician services. But not every physician performs in office settings; not all physicians perform office visits, and some services can be billed by physicians when […]
2026 CMS Proposed Physician Rule | Webinar
Recorded August 14th, 2025
1 CEU expires 7/30/26
CMS released its proposed policy changes for physician practices in mid-July this year, with the usual 60-day comment period. Our webinar will tell you what’s in it.
Provider-Based Billing | Webinar
Recorded July 17th, 2025
1 CEU expires 7/30/26
Guest presenter Pam Warren of MaineHealth
Reporting services in provider-based clinics requires knowledge of Medicare rules related to the technical and professional components of visits. It requires understanding of both the CMS 1500 form and the UB04.
Fueling Compliance: Cracking the Code on DSMT & MNT | Webinar
Recorded June 26th, 2025
1 CEU expires 6/30/26
Guest presenter Darren Goodwin of MaineHealth
Join us for an overview of Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) services., outlining key coverage criteria, provider qualifications, and documentation requirements.
Problematic Modifiers – 22, -52, -58, -78, -79 | Webinar
Recorded June 19th, 2025
1 CEU expires 6/30/26
Guest presenter Shannon McCall of HCPro
This webinar focuses on selected CPT® modifiers that tend to be problematic for coders and claims processing, with emphasis on the application of modifier-22 and -52 including commonalities and differences as stated by the AMA and supportive citations from the Medicare Claims Processing Manual.
Behavioral Health Screening and Testing
This article will review the codes and guidelines for the following behavioral health screening and testing services: Assessment of Aphasia and Cognitive Performance Testing Developmental And Behavioral Screening and Testing Neurobehavioral status examination Assessment of Aphasia and Cognitive Performance Testing CPT© codes for the assessment of aphasia and cognitive performance testing include: 96105 – Assessment […]
Anatomy of an Audit™: Complexity of Problem Addressed | Webinar
Recorded May 22nd, 2025
1 CEU expires 5/30/26
Guest presenters Pam D’Apuzzo and Debra Rossi of VMG Health
Combining CPT® guidance and audit experience, this session addresses definitions and documentation for the first element of medical decision making, the number and complexity of problems addressed. It includes guidance for all problem levels in the E/M grid.
Coding and Auditing Critical Care Notes | Webinar
Recorded May 8th, 2025
1 CEU expires 5/30/26
This webinar will review CPT® guidance for reporting critical care, including the condition of the patient, the interventions, and time spent. The webinar will discuss what services may be reported separately from critical care.
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 related to coding for medical nutrition therapy services for Medicare patients. This article also addresses common questions about coverage under the Medicare benefit with brief answers and links to the source documents for […]
Can I Get Paid For…Removal of Sutures or Staples
For a code that reimburses at about $10, can you even remember how many times you’ve been asked that question? How do I bill for suture removal again? The answer to the second question is that there are three CPT® codes for removal of sutures or staples. Back to list
Coding for Telehealth
New telehealth codes for 2025 have an invalid status indicator from Medicare See the telemedicine section of CPT Coding Changes for 2025 for details. CPT® telephone codes 99441–99443 are deleted in the 2025 CPT book. Included in this article: Telehealth Update – March 19, 2025 Place of Service update from MLN Matters CPT® changes in […]
Transferring a Sick Baby to Another Hospital
Question: Our pediatric group practices in a community hospital, without an NICU. My pediatrician was called to attend a delivery of a newborn who was born premature and in respiratory distress. The baby needed to be stabilized and transferred to a level III neonatal intensive-care unit. The pediatrician spent 90 minutes from the time the […]
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 section of our specialty page for articles about the use of modifiers 25, 51, and 59. Frequency distribution for new and established patients 2023 E/M data released at the end of […]
Coding for Prolonged Services | Webinar
Recorded April 17, 2025
1 CEU expires 4/30/26
Coding for prolonged services requires practitioner education, careful documentation and coder oversight. These codes are the opposite of “set and forget.” CPT and CMS use different codes and have different time thresholds. For some services, CMS allows time spent on services done on a different date!
Coding Guide – Advanced Primary Care Management
CMS developed new HCPCS codes for primary care practitioners who provide care management services and communications-technology based services on a monthly basis. These are an alternative to other care management codes, and acknowledge that much of the work caring for patients occurs outside of regular office visits. These Advanced Primary Care Management (APCM) codes are […]
Coding Guide – Prolonged Services
Prolonged services codes function as add-on codes to the highest-level Evaluation and Management (E/M) services in certain categories. To use prolonged care, providers must select the primary code based on time, which is explicitly stated in both the CPT® and HCPCS definitions of prolonged services. For billing purposes, the full 15 minutes of prolonged services […]
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 their facility. A visit may be with a physician, non-physician practitioner (NPP), psychologist or social worker. There are some differences in RHC and FQHC rules, but in general, a […]
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