Medical practices are assessing the impact of the change in HCC model from V24 to V28, a phased in change that begins in 2024. CMS pays Medicare … [Read more...]
Nicoletti Notes
This way for news!
Written for coders and medical professionals, Nicoletti Notes is a coding blog designed to keep you up-to-date with coding news and refreshers. Written by CodingIntel founder and coding expert Betsy Nicoletti.
Coding for telehealth
Updated (again) May 17, 2023. Will there be more changes? CMS says going forward policy changes will be through its existing rule making mechanism, … [Read more...]
2023 CPT® E/M Changes
Ready to learn about the 2023 CPT® E/M changes? There is a significant update to the Evaluation and Management (E/M) section of the CPT® book. There … [Read more...]
Payment denials for unspecified codes
From the day coders got their first glimpse at ICD-10 codes, the question went out in the land: “Will payers deny unspecified codes?” Recently, a … [Read more...]
Behavioral health coding compliance
Compliance Lessons from the OIG In March 2022, the Office of Inspector General (OIG) released a report outlining errors one psychiatrist made in … [Read more...]
How old is your oldest CPT book
My, how CPT® has grown Thank you to everyone who completed our mission critical survey: how old is your oldest CPT® book and how many pages is it? … [Read more...]
2023 RVU table with national fee amounts
Looking for 2023 work RVUs? Wondering how much a new code pays? Look no farther. You can download the 2023 CMS national RVU table below. It does … [Read more...]
Physician Fee Schedule Final Rule for Calendar Year 2023
2023 conversion factor $33.8872 (updated 1/5/2023) CMS continues to state it doesn't have the authority to extend telehealth in all geographic … [Read more...]
CMS’s 2023 shared or split services policy: document and report them correctly
What about 2023? CMS is extending the 2022 rules through 2023. When you watch this video, the rules for 2023 are the same as described for 2022. … [Read more...]
Why not bill all 99213 visits in an FQHC?
Why not bill all 99213 visits in an FQHC? (Hint: it's a good way of telling everyone that they were pretty easy visits.) Practitioners who work in … [Read more...]
What’s New in the Proposed Physician Fee Schedule Rule
Highlights of the 2022 Proposed Physician Fee Schedule rule Conversion factor decreases, sequester and PAYGO decreases still in place … [Read more...]
Consultation Codes Update
Consultation Codes Update, October 2022: The CPT books have arrived! Finally. And, with it, there is a consultation codes update for 2023. First, … [Read more...]
Medicare “Audio-Only” Telehealth Services
CMS issued multiple waivers and two interim final rules to support health care organizations and patients during the public health emergency in spring … [Read more...]
Coding Telehealth Visits
Coding telehealth visits changes faster than the weather here in New England. The resources on the site relate to Medicare policy and CPT codes and … [Read more...]
Telecoding for telemedicine
Some coders were already working from home either full time or a few days a week. Many practices and health care facilities implemented remote coding … [Read more...]
Modifier CS: cost sharing for COVID-19 testing and visits related to testing
Effective retroactively to 3/18/20, there is no cost sharing allowed for COVID-19 testing or for the evaluation visits related to the testing … [Read more...]
Payment for telephone calls during the PHE: CMS rules for phone calls
CMS rules for phone calls has changed during the course of the pandemic. Prior to the public health emergency these had a status indicator of … [Read more...]
CMS update on medical record documentation for E/M services
The world as we knew it Both the 1995 and 1997 evaluation and management (E/M) documentation guidelines stated that ancillary staff could record a … [Read more...]
CPT® codes (99421-99423) – and payment for – online digital evaluation and management (E/M) services
Be sure to read the telemedicine COVID-19 article for the latest information. There are CPT codes for online digital E/M services. CPT … [Read more...]
New versus established patient visits
There are other articles on CodingIntel about the difference between new and established patients, and the rules haven’t changed, but that doesn’t … [Read more...]