The AMA developed CPT® code 99417 for 15 minutes of prolonged care, done on the same day as office/outpatient codes 99205 and 99215. Medicare has … [Read more...]
Articles
Spotlight on up-to-date coding
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...]
Office Visit Fees in 2021
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 … [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 … [Read more...]
Coding Telehealth Visits
Coding telehealth visits changes faster than the weather here in New England. We've assembled these resources to answer your questions about what … [Read more...]
Behavioral health and telemedicine
Updated May 15, 2020 Behavioral health services have long been on Medicare’s list of services that could be provided via telemedicine. However, … [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
New! April 17, 2020 Finally! CMS has released guidance about paying for telehealth services in Rural Health Centers (RHCs) and Federally Qualified … [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: CMS update
CMS will pay for phone calls using codes 99441—99443. These services previously had a status indicator of non-covered. 99441--99443 have been … [Read more...]
Telemedicine and COVID-19 FAQ
Resources to download regarding telehealth CMS Interim Rule - March 30, 2020 CMS Interim Rule - April 30, 2020 "Coding and Reimbursement … [Read more...]
CMS update on medical record documentation for E/M services
The world as we knew it Both the 1995 and 1997 evaluation and management (E/M) documentation guidelines stated that ancillary staff could record a … [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...]
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