The information in this post applies to services provided PRIOR TO 1/1/2023 Coding for services done by hospitalists and other specialty physicians … [Read more...]
Behavioral Health Integration and CCM Codes | Reference Sheet
This updated quick reference sheet includes the description for Behavioral Health Integration and CCM codes codes, time requirements, reimbursement … [Read more...]
Diagnosis Coding for Screening Colonoscopy
Some of you have read my article on coding for screening colonoscopy. The questions I get about that article are all related to diagnosis coding. The … [Read more...]
What Does CMS’s Modifier 25 Proposal Mean to You? (I wish I knew)
Coding. Why does it keep changing? The article you are looking for was out of date, and we removed it. May we suggest... Using Modifier 25 | … [Read more...]
2019 CPT® changes
Recorded December 13, 2018 It's our annual overview of new CPT® codes. Get up to speed on the new codes and 2019 CPT® coding changes. This is a … [Read more...]
CMS Physician Fee Final Rule for 2019 | Webinar
Recorded November 20, 2018 The wait is over! Hear what coding and payment policies CMS is implementing for January 1, 2019 and how they will affect … [Read more...]
Care Management in Primary Care Practices | Webinar
Recorded September 20, 2018 @ 12:00 pm (EST) Primary care practices can be reimbursed for the non-face-to-face work of caring for chronically ill … [Read more...]
HCC’s in Brief | The Difference Between CMS-HCC and HHS-HCC
Demographics and diagnoses Risk adjusted diagnosis coding is a model used to predict future health care costs based on demographics and diagnoses. It … [Read more...]
Critical Care Services Rule | Two Physicians Billing for Same Time Period
Question: Where does it say in CPT® that two physicians can’t bill for the same period of time when performing critical care? Answer: It … [Read more...]
Fee-for-Service Medicine | The Rumors of My Death Have Been Greatly Exaggerated!
Let me start with apologies for stealing Mark Twain’s words!  And, a quick search will show I'm not the only one to apply these words to … [Read more...]
Intensive Behavioral Counseling for Cardiovascular Disease, HCPCS Code G0446
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...]
Are Start and Stop Times Required for Non Face-to-Face Prolonged Care Services?
Question: Regarding non face-to-face prolonged care, does Medicare require start and stop times, they way they do for prolonged face-to-face care? … [Read more...]
Coding Guide – Behavioral Health Services
This guide will discuss CPT® coding for behavioral health services. It includes services performed by therapists, psychiatrists and psychiatric nurse … [Read more...]
Coding Guide – CPT® and HCPCS Code Modifiers
Table of Contents Modifier introduction Initial evaluation – minor procedure E/M service same day Initial evaluation – major procedure … [Read more...]
Coding Guide – Medicare Incident-to and Shared Services
Medicare has specific rules related to billing for non-physician practitioners (NPPs). This guide will discuss billing for nurse practitioners, … [Read more...]
CMS Proposed Changes in the 2019 Physician Fee Schedule Rule | Webinar
Recorded August 16, 2018 Some Fee Schedule rules are almost boring, but not this year! CMS is proposing significant changes to the payment … [Read more...]
Coding Guide – Preventive Medicine Services
Cut through the confusion about preventive medicine, wellness visits, adding a problem-oriented visit and the new HCPCS prolonged services codes for … [Read more...]
Changes in HCC Diagnosis Coding from V22 to V23: What You Need to Know
CMS pays Medicare Advantage plans differentially based on Hierarchical Condition Category (HCCs). This coding model uses demographics and diagnoses … [Read more...]
CMS Proposes Significant Changes to E/M Requirements
Coding. Why does is keep changing? This post was out of date and has been removed. For information about E/M requirements, see these … [Read more...]
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...]
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