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...]
Articles
Spotlight on up-to-date coding
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: Caring for a critically ill or injured patient Explanation: Critical care … [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...]
Incident To Services – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an … [Read more...]
Coding for Prolonged Services: CPT and HCPCS Codes
Common rules: Prolonged services codes are add-on codes to E/M services. In order to use prolonged care, the primary code must be selected … [Read more...]
Nursing Facility Visits
Definition Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing … [Read more...]
Preventive Medicine Services – Medicare
Medicare has very specific requirements for preventive services. What can you bill, what must you document? This article covers all the bases … [Read more...]
Coding Multiple Procedures | Examples with Modifiers
Biopsies and lesion destruction codes are often performed at the same patient visit. This leads to questions about bundling and modifiers. There are … [Read more...]
Interprofessional Internet Consultations
CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 These codes were updated in 2023. Codes 99446, … [Read more...]
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 … [Read more...]
E/M Frequency Data for Surgical Specialties
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. Unfortunately, there … [Read more...]
E/M Frequency Data for Psychiatrists
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. This is the data for … [Read more...]
E/M Frequency Data for Infectious Disease, Pulmonary Medicine and Cardiology
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. Infectious disease, … [Read more...]
Multiple E/M Services in the Same Calendar Day
The AMA has added a new subsection in the 2024 E/M section addressing how to report E/M services when there are multiple encounters in the same day. … [Read more...]
Psychiatric Collaborative Care Management Services
Psychiatric Collaborative Care Management Services 99492, 99493, 99494 Care Management for Behavioral Health 99484 PCCM quick reference … [Read more...]
Teaching Physician – Primary Care Exception
CMS updated the teaching physician rules in 2019, and this article reflects the change. On April 26, 2019 CMS released Transmittal 4283. The … [Read more...]
Two Visits for the Price of One? | Multiple Medical Visits on the Same Day
Patients often schedule two medical appointments on the same day with physicians of different specialties. It’s convenient for them. It saves travel … [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...]
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