Betsy Nicoletti, Author at CodingIntel Page

ICD-10-CM Chapter Specific Guidelines – Chapters 17–20

The ICD-10-CM Official Guidelines for Coding and Reporting sets the precedent of rules that all diagnostic coders must abide by. Section I.C. covers the chapter-specific guidelines. These offer detailed information about various conditions that require more thorough reporting guidance than the general guidelines provide. Reading the guidelines in their entirety is incredibly important, but this […]

ICD-10-CM Chapter Specific Guidelines – Chapters 14–16

ICD-10-CM Chapter Specific Guidelines – Chapters 11–13

Smoking Cessation, Substance Use Counseling, Screening, and Intervention Coding, 99406-99609

Although the use of tobacco products is on the decline in the United States, the consumption of alcohol and other addictive substances remains a common preventable problem. As a result, the American Medical Association’s (AMA’s) CPT Editorial Panel included a spotlight on reporting tobacco, alcohol, and substance use cessation, counseling, screening, and intervention codes in […]

ICD-10-CM Chapter Specific Guidelines – Chapters 7–10

Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]

ICD-10-CM Chapter Specific Guidelines – Chapters 4–6

ICD-10-CM Chapter Specific Guidelines – Chapters 1–3

FAQ: Scoring Elements in the E/M Guidelines

Scoring MDM elements can be challenging for E/M services This post includes questions related to: Major/Minor procedure Data Elements (with link to additional resources) General questions about the guidelines Using time (with link to additional resources) Social determinants of health Major or minor procedure? Question: I have a question about how to determine if a […]

Consent for Communication Technology-Based Services (CTBS)

Both CPT and CMS have developed codes for non-face-to-face communication-based technology services in recent years. In addition to care management services, these include interprofessional consults, remote physiologic and therapeutic monitoring, and on-line digital E/M services In the 2020 Physician Fee Schedule Final Rule, CMS clarified the type of patient consent that is required to perform […]

Remote Therapeutic Monitoring

There are six remote therapeutic monitoring codes in the general medicine section of CPT® which may be performed by physicians, PAs and NPs and other practitioners such as psychologists, LCSWs, physical therapists and occupational therapists These codes are for non-physiologic measures and the results can be uploaded digitally or reported by the patient A physician, […]

Remote Physiologic Monitoring Treatment Management Services

This is an overview of coding for Digitally Stored Data Services/Remote Physiologic Monitoring in the E/M section of the CPT book. There are more detailed articles for the individual codes on CodingIntel. Put the code in the search box to find them. Medical practices can use these devices to monitor a patient’s health metrics, assess […]

Blood Pressure Self-Measurement: Education, Training and Analysis | CPT® Codes 99473, 99474

There are two CPT® codes specifically for blood pressure self-measurement and management. The first is for patient education and calibration of a home blood pressure device The second is for reviewing data collected by the patient at home, with a report and communication back to the patient 99473 Self-measured blood pressure using a device validated […]

ICD-10-CM Conventions, Structure, and Format: Section I.B

The first step to finding the most accurate code is to confirm that you are working with the correct version of the ICD-10-CM Official Guidelines for Coding and Reporting. The correct version may be the most recent update, or – in the context of retrospective coding– it may need to be a previous version that […]

Compliance Guide

You may have heard about the “Seven Elements for an Effective Compliance Plan.” In fact, if you enter that term in a popular web browser “about 575,000” results appear within seconds. Fortunately, compliance and enforcement agencies endorse the elements and provide great examples on what to do – without having to delve much into those […]

CMS Implemented G2211 in 2024

CMS releases G2211 FAQ: Finally! Eight months after implementing G2211 CMS has released a FAQ document answering questions they’ve received via email and during Open Door Forums. The link is below. Some of the document reiterates information from the Federal Register and MLN Matters article, and some is new. G2211 Visit complexity inherent to evaluation […]

ICD-10-CM: 2025 Updates | Webinar

Recorded September 26th, 2024

Guest Presenter Adrienne Commeree, MLS, RHIA, CPC, CPMA, CCS, CEMC, CPIP

The webinar will discuss the FY 2025 ICD-10 -CM code and guidelines updates. We will look at the changes the 2025 ICD-10-CM code book- most will be in the Alphabetic Index and Tabular list.

What’s New in the Proposed Physician Fee Schedule Rule

This article describes the proposed HCPCS codes in the PFS with the proposed payment and highlights for each code set. Coding highlights from the 2025 PFS proposed rule Medicare releases proposed policy changes for medical services for the next year each July, accepts comments on the proposals for 60 days, and sends out the final […]

“xxxA” – ICD-10-CM Placeholder Code X and 7th Character Extension

Recently, while reviewing terms people use to find CodingIntel I was surprised to find that people were searching for “xxxA.” At first, I was afraid searchers were looking for a different kind of site….or sight. But searchers were looking for information about placeholder code X and 7th character extension A. These are typically used on […]

The First Element of MDM: Number and Complexity of Problems Addressed

E/M elements for MDM There are three elements in medical decision-making and this article describes the first of three When selecting a level of service based on medical decision-making two of the three elements are required CPT® has developed definitions for many of the components in the MDM chart. The examples listed in the definitions […]

The Third Element of MDM: Risk of Complications

The third element of MDM: risk of complications and/or morbidity or mortality of patient management at the encounter Coding for E/M services There are three elements in medical decision-making and this article describes the third, the risk of complications and/or morbidity or mortality related to patient management When selecting a level of service based on […]

The Second Element of MDM: Amount and/or Complexity of Data

There are three elements in medical decision-making and this article describes the second, arguably, the most complex of the three elements When selecting a level of service based on medical decision-making two of the three elements are required CPT® has developed definitions for many of the components in the MDM chart. This article describes the definitions […]

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