Aftercare visit codes are assigned in situations in which the initial treatment of a disease has been performed but the patient requires continued … [Read more...]
Articles
Spotlight on up-to-date coding
National Coverage Determination: PrEP for HIV Prevention | HCPCS Code G0011
Physicians and qualified health professionals (QHP) can gain reimbursement for up to eight counseling sessions per year for HIV risk assessment, risk … [Read more...]
How Fees are Set in the Medicare Fee Schedule
How does Medicare set its fees? This is important for other payers because commercial payers often use the values set by Medicare to calculate their … [Read more...]
CPT® Coding Changes
Updates to the CPT® Manual: 2025 Edition The 2025 edition of the CPT® Manual confirms hundreds of code changes that take effect Jan. 1, 2025, … [Read more...]
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 … [Read more...]
ICD-10-CM Chapter Specific Guidelines – Chapters 14–16
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 … [Read more...]
ICD-10-CM Chapter Specific Guidelines – Chapters 11–13
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 … [Read more...]
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 … [Read more...]
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 … [Read more...]
ICD-10-CM Chapter Specific Guidelines – Chapters 4–6
Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters … [Read more...]
ICD-10-CM Chapter Specific Guidelines – Chapters 1–3
Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters … [Read more...]
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 … [Read more...]
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 … [Read more...]
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 … [Read more...]
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 … [Read more...]
ICD-10-CM Conventions, Structure, and Format: Section I.A
As you read this article, it will be helpful if you have the ICD-10-CM book in front of you. You can download a pdf copy here. And even if you … [Read more...]
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 … [Read more...]
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 … [Read more...]
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 … [Read more...]
Critical Care Services
Definition and Explanation of Critical Care Service Definition: Coding service for caring for a critically ill or injured … [Read more...]
Commonly Performed Procedures in Primary Care
These reference sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick … [Read more...]
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