Diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an … [Read more...]
Articles
Spotlight on up-to-date coding
Coding for Medical Nutrition Therapy Services
Medical Nutrition Therapy Services (MNT) have been a covered benefit under Medicare since the early 2000’s. This article will describe the rules … [Read more...]
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...]
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...]
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...]
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...]
Principal Care Management (PCM) Services – CPT codes in 2022: 99426–99427
In 2020, CMS developed two codes for principal care management, G2064 and G2065. These are replaced in 2022 by four CPT® codes 99424 and 99425 are … [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...]
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