This article includes information primarily from the 2024 Physician Fee Schedule Final Rule, but also the 2025 OPPS Fee Schedule in order to address … [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.
Physician Fee Schedule Final Rule for Calendar Year 2025
2025 conversion factor $32.3465 (updated 11/19/2024) Coverage of new HCPCS codes On November 1, CMS released the final 2025 Medicare physician fee … [Read more...]
What’s New in the Proposed Physician Fee Schedule Rule
This article describes the proposed HCPCS codes in the PFS with the proposed payment and highlights for each code set. Coding highlights from the … [Read more...]
“xxxA” – ICD-10-CM Placeholder Code X and 7th Character Extension
Recently, while reviewing terms people use to find CodingIntel I was surprised to find that people were searching for “xxxA.” At first, I was afraid … [Read more...]
Consultation Codes
First, CMS stopped recognizing consult codes in 2010. Outpatient consultations (99241—99245) and inpatient consultations (99251—99255) were still … [Read more...]
CMS’s 2024 Shared or Split Services Policy: Document and Report Them Correctly
In 2024, CPT expanded its definition of split/shared services, CMS updated their requirements. CPT expanded its definition of split/shared … [Read more...]
Billing for Pap Smear
Billing for pap smears in a physician practice can be confusing for clinicians and coders alike. Pap smears can be screening services or … [Read more...]
G0101 Pelvic and Breast Exam
Medicare developed two HCPCS codes for screening services for women Both G0101 (screening breast and pelvic exam) and Q0091 (obtaining a screening … [Read more...]
CPT® Codes (99421-99423) – and Payment for – Online Digital Evaluation and Management (E/M) Services
Or, as I call them: message, manage, message. There are CPT codes for online digital E/M services. CPT developed a set of CPT® codes for use … [Read more...]
2024 RVU table with national fee amounts
Looking for 2024 work RVUs? Wondering how much a new code pays? Look no farther. You can download the 2024 CMS national RVU table below. It does … [Read more...]
HCC Coding: V24 versus V28
Medical practices are assessing the impact of the change in the HCC model from V24 to V28, a phased in change that begins in 2024. CMS pays … [Read more...]
Facility versus Non-Facility in the Physician Fee Schedule
Understanding facility versus non-facility in the physician fee schedule explains the RVU and payment differences that practices receive when … [Read more...]
HCPCS Code G0136 for Assessment Social Determinants of Health (SDoH)
This is information from the 2024 Physician Fee Schedule Final Rule, released Nov. 2, 2023. New CPT and HCPCS codes, and CMS policy changes are … [Read more...]
CMS Finalizing Principal Illness Navigation (PIN) Services
This is information from the 2024 Physician Fee Schedule Final Rule https://public-inspection.federalregister.gov/2023-24184.pdf CMS developed … [Read more...]
CMS Adopts Codes for Caregiver Training Services (CTS)
This is information from the 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023. You can read it for yourself by downloading the pdf … [Read more...]
Medicare Coverage for Marriage and Family Therapists and Mental Health Counselors
In the Consolidated Appropriations Act, 2023 Congress mandated that Medicare provide coverage and payment for the services of health professionals who … [Read more...]
Coding for Telehealth
New telehealth codes for 2025 have an invalid status indicator from Medicare See the telemedicine section of CPT Coding Changes for 2025 for … [Read more...]
Coding Clinic Update, 2Q, 2023
Dr. Kennedy has generously allowed me to share his summary. He emphasizes that he is paraphrasing the recent advice in the spirit of “fair use” and we … [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
Once again, with feeling: coding for behavioral health It's been a year (seems like a minute) since the OIG released a report on coding for … [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...]