In 2019, CPT® changed the definition of code 10021 and deleted 10022. Read on for a review of these changes, as well as examples and additional … [Read more...]
Articles
Spotlight on up-to-date coding
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, Physician Assistants as shared services in the hospital. These rules are explained … [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 Starting January 1, 2016, CMS began to recognize and reimburse physicians and Non-Physician … [Read more...]
Exam | Documentation Guidelines for E/M Services
Definition Exam is one of the three key components (history, exam and medical decision making) of Evaluation and Management Services. Read about … [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...]
Using Time to Select a Code
Some Evaluation and Management codes, and some other codes are defined by the amount of time of the service. When a CPT® code is defined by time, the … [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. Medical … [Read more...]
Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442
The USPSTF recommends screening for alcohol misuse and behavioral interventions for individuals whose screening results are positive. Medicare pays … [Read more...]
Not all emergency surgery should be coded at the highest level | E/M Services and MDM
Surgeons sometimes think that the E/M service on the date of every emergency surgery is the highest level E/M. 99285 or 99223. This article … [Read more...]