Articles

Spotlight on up-to-date coding

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 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 E/M changes for 2021 for codes … [Read more...]

An overview of the revised MDM

Medical Decision Making: selecting the correct level of service for codes 99202—99215 in 2021: In 2021, E/M codes 99202—99215 have a changed … [Read more...]

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

E/M changes for 2021 for codes 99202—99215 There are three elements in medical decision-making and this article describes the first of three … [Read more...]

The second element of MDM: amount and/or complexity of data

E/M changes for 2021 for codes 99202—99215 There are three elements in medical decision-making and this article describes the second, arguably, … [Read more...]

E/M Changes in 2021 – Shared Services

The CPT® book defines shared or split services in 2021. Although the concept of shared or split services has been around for a long time, it was … [Read more...]

E/M 2021 Changes – History and Exam

History and exam for new and established patient visits in 2021: CPT® revised the definitions of and documentation requirements for new and … [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...]

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

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...]

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...]