Articles

Spotlight on up-to-date coding

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 Hospitalists

Hospitalists became a recognized specialty by CMS starting in 2017, and we now have frequency E/M data for the specialty. There are probably still … [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...]

What is a Coverage Policy?

National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) are Medicare’s coverage policies that describe medical necessity for … [Read more...]

Compliance Issues in ICD-10 Coding for Risk Based Contracts and HCCs

Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here's an important excerpt. "Code all documented … [Read more...]

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442

The US Preventive Services Task Force (USPSTF) recommends screening for alcohol misuse and behavioral interventions for individuals whose screening … [Read more...]

Coding for Hernia Repair

CPT® revised the codes and concepts used for coding for hernia repair. These are significant changes for surgical procedures that are used very … [Read more...]

Principal Care Management (PCM) Services – CPT codes 99424—99427

There are four principal care management codes 99424 and 99425 are for time spent by a physician or other qualified health care professional … [Read more...]

Chronic Care Management

Medicare and private payers cover chronic care management services if a patient has two or more serious conditions that are expected to last at least … [Read more...]

Transitional Care Management

This article provides answers to frequently asked questions related to transitional care management services. It includes details about billing for … [Read more...]

Outpatient Diabetes Self-Management Training (DSMT) Services

Diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an … [Read more...]

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