Articles

Spotlight on up-to-date coding

Depression coding in Hierarchical Condition Coding (HCC)

Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, … [Read more...]

HCC coding: round up of chronic conditions

I saw on twitter recently that COPD was the third leading cause of death in the U.S. If it was on twitter, it must be true, right? This article … [Read more...]

Don’t forget Care Plan Oversight

There are two sets of codes for care plan oversight, CPT (99374–99380) and HCPCS codes (G0181, G0182) The requirements for each are different, … [Read more...]

Billing medical practice services for patients on hospice

Overview of hospice care Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their … [Read more...]

Prolonged services codes for Medicare preventive medicine services: G0513, G0514

There are HCPCS prolonged services codes to be used with Medicare preventive services reported based on time. Wellness visits and prolonged care … [Read more...]

Dear Resident, Do you Understand Relative Value Units (RVUs)?

Measuring physician productivity with work RVUs: News flash! Physicians are more interested in medicine than coding. No doctor undertook the … [Read more...]

CPT^® coding changes – 2020

2020 coding changes For a summary of this year's CPT® coding changes download the handout and watch the webinar here. We provide a review of CPT® … [Read more...]

Compliance issues in ICD-10 coding for risk based contracts and HCCs

Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here’s an excerpt. “Code all documented conditions, … [Read more...]

Risk Coding for Medical Practices and Outpatient Services

This article discusses the dos and don’ts of assigning diagnosis codes in medical practices for risk adjustment, using the HCC system. Watch our … [Read more...]

CPT^® code 99483: Cognitive assessment and care plan services

Definition of CPT® code 99483 99483: Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in … [Read more...]

Psychiatric Collaborative Care Management Services

Psychiatric Collaborative Care Management Services 99492, 99493, 99494 Care Management for Behavioral Health 99484 Psychiatric Collaborative … [Read more...]

Selecting CPT^® rules for excision of skin lesions

Many medical practices perform skin procedures. A patient may see a dermatologist, a family physician or a surgeon when the time comes to find out, … [Read more...]

Destruction of benign or pre-malignant lesions

Finding the right code for lesion destruction is not easy. The codes are distributed in the CPT® book in the integumentary, digestive, male genital … [Read more...]

What’s the difference between B20 and Z21? Which is right for positive HIV status?

In this post ICD-10-CM diagnosis coding for positive HIV status Update to HIV coding in 2022 Medical practice reimbursement for individual … [Read more...]

History | 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. Definition History is … [Read more...]

CPT^® and CMS rules for critical care | What’s the difference?

Good news in 2022 CMS's 2022 Physician Fee Schedule Final Rule brought a sigh of relief to many groups. CMS is adopting CPT® prefatory language and … [Read more...]

Co-surgery, Team surgery, Assistant at surgery

Modifiers for co-surgery, team surgery and assistant at surgery CPT® has specific modifiers for co-surgery, team surgery and assistant at surgery. … [Read more...]

Modifier 95: telemedicine

During the public health emergency (PHE), CMS and private payers relaxed the restrictions on telehealth. These changes are intended to be temporary. … [Read more...]

Wound Care | CPT^® Codes for Debridement

Health care organizations have started wound care clinics to care for patients with non-healing wounds The care of a post-op wound is done by the … [Read more...]

What is a Coverage Policy?

National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) are Medicare’s coverage policies that describe medical necessity for … [Read more...]