Definition Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing … [Read more...]
Articles
Spotlight on up-to-date coding
Modifier 24 and 25
This summary of the rules regarding modifier 24 and 25 is a must read; it includes specific examples of when to report both an E/M and a procedure and … [Read more...]
Incident To Services – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an … [Read more...]
Moderate or High MDM – General Surgery
Although we expect that the AMA will update the rules for hospital and other E/M services in 2023, currently they still use the 1995/1997 guidelines, … [Read more...]
Billing Admission and Subsequent Visits for Patient Having Surgery
What if I Admit a Patient and Don't Take the patient Immediately to Surgery? Can I bill for the admission and subsequent visits if the patient … [Read more...]
Teaching physician rules and surgical procedures
The teaching physician rules describe a payment method by which Medicare pays an attending physician or teaching physician for services performed … [Read more...]
Teaching Physician – Primary Care Exception
CMS updated the teaching physician rules in 2019, and this article reflects the change. On April 26, 2019 CMS released Transmittal 4283. The … [Read more...]
How Fees are Set in the Medicare Fee Schedule
How does Medicare set its fees? This is important, as well, because commercial payers often use the values set by Medicare to calculate their fees. … [Read more...]
Certification for Home Health Services
There are two HCPCS codes that physician, nurse practitioners, clinical nurse specialists and physician assistants can use to report developing a plan … [Read more...]
Coding for Excision of Benign or Malignant Lesions
This article reviews codes and guidelines for excision of skin lesions. For additional information about minor procedures, see the additional … [Read more...]
Surgical Modifiers
This article includes: Surgical modifiers with definitions Guidelines for billing multiple surgical procedures Modifiers in the post-op … [Read more...]
Aftercare and Follow-up: ICD-10 Coding
Aftercare visit codes are assigned in situations in which the initial treatment of a disease has been performed but the patient requires continued … [Read more...]
Critical Care for General Surgery and Trauma Surgeons
Critical care provided as a stand alone service is based on the seriousness of the patient, the types of interventions, and time Critical care … [Read more...]
Screening for Other Sexually Transmitted Illnesses (STI)
This article covers CPT® and diagnosis codes used for screening for other sexually transmitted illnesses. It includes descriptions and screening … [Read more...]
High Intensity Behavioral Counseling to Prevent Sexually Transmitted Illnesses (STI)
CMS covers counseling to prevent STI in certain circumstances. The code is G0445. G0445 – Semiannual high intensity behavioral counseling to … [Read more...]
Non Face-to-Face Prolonged Service – 99358
This post includes: Brief video CPT® rules for prolonged care non face-to-face Using-99358-for-phone-calls Codes 99358 and 99359 are … [Read more...]
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