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CodingIntel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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Spotlight on up-to-date coding

 

 

Coding and reimbursement for lactation services

Questions about coverage and payment for breastfeeding and lactation counseling services come up regularly. Is lactation counseling separately … [Read more...]

New vaccination codes for 2022

The 2022 CPT® book has some new vaccination codes and some vaccination codes that practices have been using in 2021. These include codes for the serum … [Read more...]

When to use time to select an office visit code using the 2021 E/M guidelines

Select the level of service for codes 99202—99215 based on time or medical decision making (MDM) Time includes all time spent by the billing … [Read more...]

Prolonged services for 99202–99215: 99417, G2212

Coding for prolonged services is complicated by the fact CPT and CMS use different codes and different time thresholds. The AMA developed CPT® … [Read more...]

New! 2021 office visit code selection for medication management

The guidelines for selecting office visit codes changed in January, reducing the documentation burden on practitioners.  Psychiatrists and psychiatric … [Read more...]

HCC diagnosis coding example: diabetes, hypertension, chronic kidney disease

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 … [Read more...]

Defining problems using the new 2021 office visit guidelines

The AMA has developed specific definitions for problems when selecting a level of service for office visit in 2021 The first element is the number … [Read more...]

Chronic Care Management

•  Medicare covers chronic care management services if a patient has two or more serious conditions that are expected to last at least a year. •  … [Read more...]

Essential documentation for medication management and psychotherapy

When providing both medication management and psychotherapy, practitioners need to document the time spent in psychotherapy and describe the therapy. … [Read more...]

Documenting and coding observation services in 2021

For Medicare patients in observation, the consulting physician uses new and established patient visit codes. Only the admitting physician can use … [Read more...]

Medicare “Audio-Only” Telehealth Services

CMS issued multiple waivers and two interim final rules to support health care organizations and patients during the public health emergency in spring … [Read more...]

Coding Telehealth Visits

Coding telehealth visits changes faster than the weather here in New England. The resources on the site relate to Medicare policy and CPT codes and … [Read more...]

Behavioral health and telemedicine during the PHE

In this post Overview of behavioral health services via telemedicine during the PHE Overview of behavioral health services after the PHI … [Read more...]

Is it or isn’t it a telehealth service?

Many payers and practices use the broad term telehealth to describe services that are not done face-to-face with a patient CMs describes telehealth … [Read more...]

Specimen Collection For COVID-19

CMS’s 4/30/2020 rule states that practices could bill 99211 for new or established patients during the public health emergency for COVID-19 specimen … [Read more...]

Medicare changes telehealth rules, again

Medicare changes telehealth rules, again: April 30, 2020 interim final rule with comment period … [Read more...]

Telemedicine in RHCs and FQHCs

In April, 2020  CMS has released guidance about paying for telehealth services in Rural Health Centers (RHCs) and Federally Qualified Health Centers … [Read more...]

Modifier CS: cost sharing for COVID-19 testing and visits related to testing

Effective retroactively to 3/18/20, there is no cost sharing allowed for COVID-19 testing or for the evaluation visits related to the testing … [Read more...]

Payment for telephone calls during the PHE: CMS rules for phone calls

CMS rules for phone calls has changed during the course of the pandemic.  Prior to the public health emergency these had a status indicator of … [Read more...]

Telemedicine and COVID-19 FAQ

It is a full time job in medical practices to keep current on each payer's telehealth rules, which change frequently. CMS continues to pay for … [Read more...]

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Wondering about the rules for HCC coding?

Wondering what the rules are for HCC coding, and where you can find them? This video answers your questions. The topic is important to medical practices because risk-adjusted diagnosis coding is part of Medicare Advantage contracts, many commercial contracts and Accountable Care Organizations (ACOs). Sign up for our monthly newsletter to download the whitepaper and watch the video.

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Recommended Resource

You’ve coded it, but you still have to fight to get paid! We’ve partnered with Elizabeth Woodcock to give you the tools and strategies you need.

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Payment denials for unspecified codes

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Behavioral health coding compliance

Compliance Lessons from the OIG In March 2022, … Read More...

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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

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. For more about Betsy visit www.betsynicoletti.com.

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