July 7, 2025
Recorded November 18, 2021
While there are only 159 new diagnosis codes in the ICD-10-CM code set, effective October 1, 2021, there updates to the official guidelines that coders need to know about. Not surprisingly, the guideline changes emphasize specificity. There are new codes for the Social Determinants of Health (SDoH) and who can document these in order to capture them on the claim form. There is a new code for post-COVID-19 and instructions for its use. This webinar will highlight…
Recorded October 21, 2021
Guest presenter Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC
Medical practices face new risks and opportunities as changes to the healthcare marketplace ignite the pressure to strengthen revenue cycle management (RCM). In this webinar, speaker, author, and consultant Elizabeth Woodcock provides a roadmap to optimize your practice management system, prevent denials, and strengthen cash collections. Find out about initiatives you can implement immediately.
Why not bill all 99213 visits in an FQHC? (Hint: it’s a good way of telling everyone that they were pretty easy visits.) Practitioners who work in Federally Qualified Health Centers (FQHCs) can get in the habit of billing all level three office visits, understanding that an FQHC is paid under the Prospective Payment System […]
See our on-demand webinar, Preventive medicine and Medicare wellness visits with an E/M. Question: Our physician saw a patient and did a preventive medicine service and addressed an acute, significant problem. The patient was new to us. Should we bill both as new patient visits? Answer: The last time I saw this addressed by CPT® […]
Selecting a code for an E/M service can be done based on time or MDM (except ED visits which only use MDM) Time includes all time spent by the billing practitioner on the date of service, not just face-to-face time, and counseling does not need to dominate the visit, as it did in the 1995/1997 […]
Question Does HCPCS code G0444 require a full 15 minutes, or can you use it if 8 minutes are documented? Answer The reason for this question is that some codes follow the CPT unit of time rule, from the front of the CPT book. And some codes require the full length of time. How do […]
Recorded June 12th, 2021
It’s here, the first major changes for selecting an E/M service since 1997. Clinicians are only required to document “a medically appropriate history and/or physical exam, when performed.” Code selection is based on time or medical decision making. The instructions on using time for codes 99202—99215 are all new.
Question: I understand from your article about prolonged services in 2021 that CMS won’t pay for prolonged code 99417 and instead developed a HCPCS code for the service. (G2212) Do you have any recommendations about how to manage this in the office? Answer: Although in general, I believe most clinicians can code for most of […]
Recorded June 16th, 2021
The AMA issued technical corrections related to the 2021 E/M guidelines for new and established office visit codes 99202—99215. The most significant changes were how data is credited and a clarification on minor and major procedures. During this webinar, we’ll audit three notes that include crediting data and procedure risk.
At some visits, psychiatrists and psychiatric NPs and PAs provide only medication management, and at some visits, they manage prescriptions and perform psychotherapy at the same encounter. There are specific rules for office visit code selection for medication management done at the same encounter as psychotherapy. Watch the video below for an explanation about how […]
If a picture is worth 1000 words, what’s an example worth? An example can show in a glance what it takes paragraphs to write and explain. The one I’ve included in this article shows risk scores for a few common chronic conditions, coded two ways. One follows ICD-10 rules and results in a six-fold increase […]
Recorded May 20, 2021
The coding and reimbursement system is anything but simple. This webinar will explain how services are paid in fee-for-service medicine, and the use of CPT codes, HCPCS codes, ICD-10-CM codes, bundling, and payer policies. It is a broad overview aimed at describing “who makes up these rules” and where to look for definitive, citation-based answers.
Recorded April 15, 2021
The rules related to HCC coding in physician practices are found in the ICD-10 book itself and in CMS guidance. Long before selecting the correct code, clinicians and coders need to understand the guidelines. This session will describe the guidelines, based on citations from these definitive sources.
Looking for a coding resource for behavioral health therapists? It’s here. Therapists use CPT codes to describe what services they perform and ICD-10 codes to establish the medical necessity for the service. This 30 minute overview describes the coding rules for the psychiatric diagnostic evaluation, psychotherapy, psychotherapy for patients in crisis and interactive complexity.
It can be difficult to translate the E/M rules into patient scenarios. The guidelines seem great in theory, but how does a clinician use them and select the correct level of service? Here are ten examples. They represent the common visits in medical practices and health centers. EXAMPLE ONE 99202/99212 Patient presents at the urging […]
The first element of MDM is the number and complexity of problems addressed CodingIntel’s members-only webinars on auditing E/M services include poll questions, and looking at the poll results during our webinars, I think there is some confusion about the definition of problems. Some people selected self-limited problems for cases in which the patient had […]
When providing both medication management and psychotherapy, practitioners need to document the time spent in psychotherapy and describe the therapy. Beginning January of 2021, when billing an office visit, select the level of visit based on medical decision making, not time. If medication management is the only service performed on that date, the clinician can […]
The American Medical Association (AMA) changed the definitions for codes 99202–99215, effective 1/1/2021 Medical practices are struggling to accurately apply these new definitions to office visits There are significant shifts in the level of service calculated from 2020 to 2021 Both the AMA and CMS said that they didn’t anticipate that levels of service would […]
2022 Conversion Factor – $34.6062 CMS released the updated conversion factor for 2021, and it is $34.89. This represents about a 7.7% increase from the conversion factor released in the final rule, but is still a decrease from 2020. The RVU values for office and outpatient codes 99202—99215 were changed from 2020 to 2021. Many […]
When doing a joint injection, sometimes a separate E/M service is billed on the same day, and sometimes, it’s not. This grid will help you determine when to bill for both services, and when to bill only for the joint injection.
For Medicare patients in observation, the consulting physician uses new and established patient visit codes. Only the admitting physician can use initial and subsequent observation codes for Medicare patients in observation. Some commercial payers still recognize outpatient consults, and allow a consulting physician to bill subsequent observation codes. But Medicare does not. Questions about what […]
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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.
In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.
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