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...]
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.
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...]
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: Place of Service
Information in this article was updated July 2023, based on the 2024 Proposed Physician Fee Schedule Rule. Coding telehealth visits changes faster … [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...]
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...]
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...]
Anticoagulation Management
Currently, there are two sets of codes, three HCPCS codes and two CPT® codes. They aren’t defined exactly the same, and so take careful reading. The … [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...]
Diagnosis Coding for Screening Colonoscopy
Some of you have read CodingIntel's article on coding for screening colonoscopy. The questions we get about that article are almost all related to … [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...]
ICD-10 Coding for Suspected Cancer
Diagnosis coding for possible malignancy How would you feel if your primary care physician and your general surgeon told you-and told your insurance … [Read more...]
Who is Responsible for Coding Physician Services? The Medical Provider or the Coder?
Legally, when a physician, physician assistant (PA) or nurse practitioner (NP) enroll in a Medicare, Medicaid or commercial insurance, the … [Read more...]
OB Coder Survey | Billing Extra Visits During Pregnancy
Thank you to the 63 generous coders and billers who answered my questions about billing extra OB visits during the maternity period. If we and our … [Read more...]
What Does the Decision to Perform a Minor Procedure Really Mean?
This article is updated with CPT's March 2023 document, "Reporting CPT Modifier 25." (citation at the end of the article) The CPT article adds … [Read more...]
Can you Screen for an Existing Condition? | Diagnosis Coding for Lab Services
Sometimes, the hardest thing about coding for preventive services isn't the visit at all. It's the labs. Patients come in for an annual physical and … [Read more...]
Let’s Go to the Source! Should this Visit be Downcoded?
This article describes the use of time using the 1995/1997 guidelines. Be sure to read about the 2021 guidelines for codes 99202--99215. A … [Read more...]
HCC Diagnosis Coding: Can you Add a Code from the Past Medical History?
This post describes rules for office/outpatient coding, not facility/DRG rules. Recently a fellow coder wrote to me about risk adjusted diagnosis … [Read more...]