Articles

Spotlight on up-to-date coding

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...]

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...]

Principal Care Management (PCM) Services – CPT codes in 2022

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

Two new CPT® codes in 2020. The first is for patient education and calibration of a home blood pressure device The second is for reviewing data … [Read more...]

The first element of MDM: number and complexity of problems addressed

E/M rules for codes 99202—99215 There are three elements in medical decision-making and this article describes the first of three When … [Read more...]

An overview of the revised MDM

Medical Decision Making: selecting the correct level of service for codes 99202—99215: E/M codes 99202—99215 have a changed definition of MDM … [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 office and outpatient … [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...]

E/M 2021 Changes – History and Exam

History and exam for new and established patient visits: CPT® revised the definitions of and documentation requirements for new and established … [Read more...]

Time: using time for E/M services in 2021

The American Medical Association (AMA) revised codes 99202—99215 in 2021. These changes are in the 2021 CPT book. Beginning in 2021, time alone can … [Read more...]

Surgical Coding for Hernia Repair

An abdominal hernia is a protrusion of part of the intestines through a weakened section of the abdominal cavity; herniations can occur in other parts … [Read more...]

Procedure Coding for Colonoscopies

“A colonoscopy is the examination of the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum or small … [Read more...]

Overview of diagnosis coding for behavioral health services

Match diagnoses on the claim form to those listed in assessment The diagnosis codes on the claim form should match those in the note. If the … [Read more...]

Psychiatric diagnostic evaluation

There are two codes for psychiatric diagnostic evaluation. 90791 Psychiatric diagnostic evaluation 90792 Psychiatric diagnostic evaluation with … [Read more...]

Psychotherapy codes

Individual psychotherapy codes are time based codes They may be reported as a stand alone service, or at the same visit as medication management … [Read more...]

Psychotherapy for patients in crisis

90839 is the code for psychotherapy for crisis; first 60 minutes. 90840 is an add-on code for each additional 30 minutes of time spent with a patient … [Read more...]

Interactive complexity | CPT^® 90785

Code 90785 is an add-on code for interactive complexity and may be added on to the diagnostic psychiatric evaluation (90791, 90792), to psychotherapy … [Read more...]

When a payer comes calling | Responding to payer audit

Medical practices receive many communications from payers that aren’t indicative of a problem. A payer needs more information to process a claim. Or, … [Read more...]

Teaching Physician Rules – Psychiatric Services

In psychiatry if reporting time-based psychotherapy services, the time of the attending physician is the time used to select the code. For … [Read more...]