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.

Physician Fee Schedule Final Rule for Calendar Year 2021

If you haven't watched already, check out the 2021 Final Rule Webinar on-demand here. Conversion factor for 2021 released–updated January 6, … [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...]

Are you sure?

Coders crave certainty We coders don’t just want to do it well, or fast. We want to do it right. 100% of the time. We want our practices and … [Read more...]

CPT® codes (99421-99423) – and payment for – online digital evaluation and management (E/M) services

New for 2020! Be sure to read the telemedicine COVID-19 article for the latest information. CPT® developed three new CPT® codes for use by … [Read more...]

E/M Changes in 2021 for 99202-99215 | Overview

It's here! New definitions for codes 99202--99215 Clinicians can select new and established patient visit based on time or medical decision making … [Read more...]

CMS 2020 Proposed Rule Updates

CMS rescinds bundled payments for 2021 and accepts CPT® revisions for new and established patients Proposes new HCPCS codes for care management … [Read more...]

Medicare National Coverage Determination (NCD) for Ambulatory Blood Pressure Monitoring (ABPM): CPT^® and ICD-10 Coding

CMS released an NCD for ABPM on July 2, 2019. CMS has expanded the coverage for ABPM by allowing it for a greater range of BP measurements. Of course, … [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...]

What’s trending? Common coding questions from medical practices

CodingIntel has answers. Although CodingIntel isn’t a Q&A service, some questions come up over and over when I meet with medical practices. Here … [Read more...]

Teaching Physician Rules – Evaluation and Management Services

CMS policy update: E/M services performed under the teaching physician rules Download this teaching physician rules quick reference sheet for a … [Read more...]

2018 CERT Analysis

CMS has not released a full Comprehensive Error Rate Testing (CERT) report since 2016. But, the 2018 supplemental report provides ample information … [Read more...]

Anticoagulation Management

I continue to get questions about billing for anticoagulation management, and I’m hoping this post can put some (all?) of them to rest. First, two … [Read more...]

E/M frequency data for hospitalists

Hospitalists became a recognized specialty by CMS starting in April of 2017, and we now have frequency E/M data for the specialty. There are probably … [Read more...]

E/M in 2019: A look ahead

Now that the dust has settled from the release of the Physician Fee Schedule Final Rule, maybe it’s time for a re-cap. This article will also discuss … [Read more...]

Five urban legends about risk-adjusted diagnosis coding

Originally published on kevinmd.com When I talk to medical practices about Hierarchical Condition Category (HCCs) and risk-adjusted diagnosis … [Read more...]

NGS changing processing of same day NP/PA claims

Is NGS your MAC? Did you see their announcement that for claims processed on or after Sept 15, 2018, they will no longer deny claims for a second … [Read more...]

Diagnosis coding for screening colonoscopy

Some of you have read my blog post on coding for screening colonscopy. The questions I get about that article are all related to diagnosis … [Read more...]

HCC’s in brief | The difference between CMS-HCC and HHS-HCC

Demographics and diagnoses Risk adjusted diagnosis coding is a model used to predict future health care costs based on demographics and diagnoses. It … [Read more...]

Fee-for-service medicine | The rumors of my death have been greatly exaggerated!

Let me start with apologies for stealing Mark Twain’s words! And, a quick search will show I'm not the only one to apply these words to … [Read more...]

What’s New in the Proposed Physician Fee Schedule Rule

Summary of the 2021 Proposed Physician Fee Schedule Rule The rule was released August 3rd, and confirms CMS’s support of the AMA revised … [Read more...]