CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 These are not considered telehealth services. … [Read more...]
Articles
Spotlight on up-to-date coding
CPT® codes for fine needle aspiration
In 2019, CPT® changed the definition of code 10021 and deleted 10022. Fine needle aspiration biopsy Material is aspirated with a fine needle and … [Read more...]
Codes for skin biopsies
CPT updated certain skin biopsy codes in 2019 The codes for excision of benign and malignant lesions did not change, and codes for shave biopsies … [Read more...]
Intensive behavioral counseling for cardiovascular disease, HCPCS code G0446
Medicare pays a primary care physician or other primary care practitioner in a primary care setting to annually provide one face-to-face behavioral … [Read more...]
Screening for depression | HCPCS code G0444
Annual depression screening code G0444 Medicare pays primary care practices to screen all Medicare patients annually for depression. The service … [Read more...]
Smoking cessation coding, 99406 and 99407
Medicare and most private insurers pay for physicians, NPs and PAs to counsel patients about stopping tobacco use. Medicare waives the … [Read more...]
Behavioral counseling for obesity, HCPCS code G0447
Medicare pays for ongoing face-to-face behavioral counseling for patients with a BMI of ≥ 30, who are alert and able to participate in … [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...]
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...]
Shared Visits – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants using shared services. These rules are explained in this … [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...]
Emergency Department Visits
Definition Emergency department (ED) services are E/M services provided to patients in the Emergency Department. Explanation These services … [Read more...]
Critical Care Services
Critical care has high relative value units and payments so it's important to know the coding rules. This article describes what can be included in … [Read more...]
Minor Procedures
These cheat sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick … [Read more...]
Advance Care Planning | CPT® 99497, 99498
Advance Care Planning (ACP) and the Use of ACP CPT® Codes 99497 (Advance care planning including the explanation and discussion of advance directives … [Read more...]
Exam | Documentation Guidelines for E/M Services
This article relates to the 1995/1997 documentation guidelines, and not to office/outpatient codes 99202--99215 in 2021. Continue to use the 1995/1997 … [Read more...]
Using Time to Select a Code
Use these rules when billing for codes that use the 1995/1997 guidelines. In 2021, this does not include codes 99202--99215. What codes continue to … [Read more...]
Time based rules | Behavioral health services
Psychiatrists, psychiatric NPs and psychiatric PAs provide medication management using E/M codes and psychotherapy services. There are specific rules … [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...]
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...]