RHCs and FQHCs are paid an all-inclusive rate (AIR) or national prospective payment system (PPS) rate for any service that is defined as a visit to … [Read more...]
Articles
Spotlight on up-to-date coding
Diabetes coding in Hierarchical Condition Coding (HCC)
Introduction | Diabetes coding in HCC In fee-for-service medicine: Diagnosis coding establishes medical necessity, and may be the reason for a … [Read more...]
Depression coding in Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes medical necessity, and may be the reason for a … [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
As I'm editing this article in late 2020, I can't recall a time when I saw these codes reported by one of my clients. But, there are HCPCS prolonged … [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...]
A Bundle of (un) Joy | New CPT® bundled codes
A new baby in the family is considered a bundle of joy by friends and family members alike. New “bundled” CPT® codes arriving January 1st each year … [Read more...]
CPT® coding changes
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...]
New CPT® codes for 2018 | Anticoagulation management and education for home INR monitoring
CPT developed (and Medicare recognizes) two new codes for services related to home and outpatient international normalized ratio (INR) monitoring … [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...]
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 99492, 99493, 99494
Care Management for Behavioral Health Definition Services provided under the direction of a treating physician/NP/PA for work performed by a … [Read more...]
General Behavioral Health Integration Care Management
99484 Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other … [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?
ICD-10-CM diagnosis coding for positive HIV status Question: For an HIV positive patient without symptoms, is the correct diagnosis code Z21 or … [Read more...]
History | Documentation Guidelines for E/M Services
Definition History is one of the three key components (history, exam, and medical decision making) of Evaluation and Management Services. You can … [Read more...]
CPT® and CMS rules for critical care | What’s the difference?
There are some significant differences in critical care rules as described in CPT® and in the Medicare Claims Processing Manual.1 This makes it … [Read more...]
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