Articles

Spotlight on up-to-date coding

E/M 2021 Changes – History and Exam

History and exam for new and established patient visits in 2021 CPT® is revising the definitions of and documentation requirements for new and … [Read more...]

Time: using time for E/M services in 2021

CPT® is revising codes 99202—99215 in 2021. Beginning in 2021, time alone can be used to select one of these codes, whether or not counseling … [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...]

Medication management and Psychotherapy

Medication management performed by psychiatrists and medical psychiatric nurse practitioners and physician assistants is billed with Evaluation and … [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...]

Overview of diagnosis coding for behavioral health services

DSM-5 From the American Psychiatric Association, “The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health … [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...]

Family and group therapy codes

Group therapy Group psychotherapy is reported with code 90853. This is not a time-based code: one unit of service should be reported for each … [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...]

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

Billing for psychiatric services under the teaching physician rules Psychiatrists use two distinct sets of codes, and so must know two sets of … [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...]

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...]

Physician specialty codes and claims processing

When physicians enroll in Medicare, they self-elect their specialty designation. In the enrollment process, there are fields to indicate primary and … [Read more...]

Diagnosis coding for dermatology

Diagnosis notes for dermatology Be sure to match the diagnosis to the procedure. For example, For skin tag removal, use skin tag For … [Read more...]

Screening for skin cancer

Dermatologists frequently see patients for skin checks, to examine their skin for signs of pre-malignant or malignant lesions. Some of these patients … [Read more...]

Coding for breast procedures: biopsy, localization devices, and surgery

From biopsy to localization device to mastectomy, coding for breast procedures can be challenging. This article summarizes the rules related to these … [Read more...]

Chronic care management services (CCM), CPT^® 99491: new code in 2019

CPT® has added 99491 to the section of chronic care management codes. The other code in this section is 99490 and there are two codes in the complex … [Read more...]