Although there is a single payment for surgical procedures that have 0, 10 and 90 global days, there are frequent instances in which the surgeon … [Read more...]
Articles
Spotlight on up-to-date coding
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...]
Collaboration of Care Model for Behavioral Health Integration (CoCM.BHI)
Definition HCPCS codes that describe collaboration of care services in primary care practices for patients with behavioral health … [Read more...]
Care Management for Behavioral Health Conditions
Care Management for Behavioral Health Conditions Overview CMS developed HCPCS G0507 code for care management performed by clinical staff for … [Read more...]
New modifier for telemedicine in 2017: modifier 95
During the public health emergency, CMS and private payers relaxed the restrictions on telehealth. These changes are intended to be temporary. There … [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...]
Everyday Coding for Medical Practices
How can a practice increase its revenue? The easiest way is by collecting for services already performed, and the first step in that process is … [Read more...]
Medical Decision Making | Documentation Guidelines for E/M Services
Definition Medical decision making (MDM) is one of the three key components of evaluation and management services. (Make sure you read about the … [Read more...]
Global Surgical Package: an overview
Need a quick summary of the global surgical package and frequently used modifiers, including modifiers 54 & 55? This article from CodingIntel will … [Read more...]
Nursing Facility Visits
Definition Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing … [Read more...]
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, Physician Assistants and other office staff incident to a physician services in an … [Read more...]
Moderate or High MDM – General Surgery
Accurately select the level of medical decision making, using the 1995 and 1997 Documentation Guidelines. This article provides examples of moderate … [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...]
Laceration Repair
Wound repair is classified as Simple, Intermediate or … [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 calcualte their fees. … [Read more...]
Certification for Home Health Services
There are two HCPCS codes for certification and re-certification of Medicare covered home health services The CARES Act of March 2020 allows nurse … [Read more...]
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