CodingIntel Editor, Author at CodingIntel Page

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

Included in this article: Telehealth and the Government Shutdown – October 1, 2025 Telehealth Codes for 2025 Telehealth Update – March 19, 2025 Place of Service Update from MLN Matters CPT® Changes in 2025 The Future of Telehealth and Virtual Care CMS Telehealth FAQ Calendar Year 2025 Continuing resolution passed Nov. 2025 Congress passed a […]

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 […]

Coding Guide – Federally Qualified Health Centers

If you are looking for a guide to coding for Rural Health Center (RHC) or Federally Qualified Health Center (FQHC) visits, here it is. Clinicians in RHCs and FQHCs use CPT® and ICD-10-CM codes to select their services, but these are submitted with HCPCS qualifying visit codes. It’s easy for clinicians in these mission driven […]

Performing Services that Increase Primary Care Revenue

Wellness Visits and Problem Visits at the Same Encounter Transitional Care Management Chronic Care Management Advance Care Planning HCPCS codes with low RVUs Advanced Primary Care Management Services | G0556, G0557, G0558 Post-operative Care Services Add-on Code | +G0559

Behavioral Health Coding Compliance

Once again, with feeling: coding for behavioral health There are two videos on this page that describe OIG audits of behavioral health services. They are evergreen. If you’re new to the field of behavioral health coding, they are cautionary tales of what not to do. Coding for Behavioral Health Compliance lessons from the OIG It’s […]

CMS Adopts Codes for Caregiver Training Services (CTS)

This is information from the 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023. You can read it for yourself by downloading the pdf below. 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023 MLN Matters article Jan. 2024 – PDF These are not on the telehealth list; they are in person services […]

Interprofessional Internet Consultations

CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 See also HCPCS codes developed in 2025 for behavioral interprofessional consults | G0546–G0551 These codes were updated in 2023. Codes 99446, 99447, 99448, 99449 and 99451 may now be performed by physicians and other qualified health care professionals. Because these codes […]

High Intensity Behavioral Counseling to Prevent Sexually Transmitted Illnesses (STI) and PrEP G0445

CMS covers counseling to prevent STI in certain circumstances. The code is G0445. G0445 – Semiannual high intensity behavioral counseling to prevent STIs, individual, face-to- face, includes education skills training & guidance on how to change sexual behavior, performed semi-annually, 30 minutes. The patient must be referred by a primary care provider to be eligible […]

Screening for Other Sexually Transmitted Illnesses (STI)

This article covers CPT® and diagnosis codes used for screening for other sexually transmitted illnesses. It includes descriptions and screening criteria. To tell whether or not you can collect a co-pay for the testing or not can be found on the U.S. Preventive Services Task Force (USPTF) website [1]. The Affordable Care Act mandated that […]

Coding Guide – Teaching Physician Rules

The teaching physician guidelines are Medicare rules that allow for payment for services that are performed jointly between a resident and a licensed attending physician (the teaching physician). This downloadable coding guide from CodingIntel provides an explanation of teaching physician rules for E/M services and specialty specific services.

Anticoagulation Management

There are a few remarkable things about coding for anticoagulation management services. First, payment for these services bolsters Medicare’s support for primary care. This monitoring is typically done by either primary care or cardiology and was considered part of the pre-and post-work for an office visit. Although there were CPT® codes for anticoagulation management prior […]

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