CodingIntel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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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.

Changes in HCC diagnosis coding from V22 to V23: what you need to know

CMS pays Medicare Advantage plans differentially based on Hierarchical Condition Category (HCCs). This coding model uses demographics and diagnoses … [Read more...]

How to improve the accuracy of your diagnosis risk scores | Dr. Edwin Knights

This reference is the companion resource for the webinar I presented in June with Edwin Knights, M.D., Improving the accuracy of your diagnosis risk … [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...]

Reimbursement for Shingrix, the new zoster vaccine | 90750

At the end of 2017, there was news that a new vaccine for shingles, Shingrix, was significantly more effective than the older vaccine, Zostavax.  The … [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...]

Are you missing the initial annual wellness visit? | G0438

After I gave a presentation at a family medicine conference a physician said to me, “What you just told me will pay for the entire cost of my coming … [Read more...]

Three things you may have missed on CodingIntel.com

Coding. Why does it keep changing? This article was out of date and has been removed. Visit our coding library to see the latest coding … [Read more...]

Medical necessity isn’t medical decision making

Have you heard of Talk Ten Tuesdays? It’s an internet radio program hosted by Chuck Buck and Dr. Erica Remer, and every week they discuss current … [Read more...]

Billing for pap smear

Clinicians often ask what codes to use when billing for a pap smear provided during a preventive medicine service or other problem-oriented E/M … [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?

I received this question recently and want to share it with you. “Since the decision to perform a minor procedure is included in the payment for the … [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 … [Read more...]

HCCs in Medical Practices | Risk Diagnosis Coding

What are HCCs and why do I need to know about them? Hierarchical Condition Category (HCC) is a coding system developed by Medicare to pay Medicare … [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...]

Avoid these 4 costly errors when coding minor surgical procedures

Does your practice perform any minor or major procedures? If so, this post is for you! Primary care practices and urgent care centers should pay … [Read more...]

A Rose by Any Other Name | EMR and Compliance

The blog post below, written in 2017, discusses the issue of copying and pasting in electronic health records. Since then, CMS has changed its stance … [Read more...]

7 sure fire ways to owe the government $4 million in fines and repayments | Coding Compliance

Most practices aren’t looking to pay the government any money in fines and repayment because of coding errors. Two recent OIG settlements described … [Read more...]

Reporting a problem-oriented visit on the same day as Welcome to Medicare (G0402) or Initial and Subsequent Wellness Visit (G0438, G0439)

When can you report a problem oriented visit with the Welcome to Medicare (G0402), or Initial or Subsequent (G0438, G0439) Medicare Wellness … [Read more...]

G0101 Pelvic and Breast Exam

Medicare developed two HCPCS codes for screening services for women, without certain frequency time limits G0101(screening breast and pelvic exam) … [Read more...]

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Looking for training on the new E/M Guidelines for 2021?

"Documentation Essentials for Codes 99202-99215 in 2021" is now available!

Take the two hour course on-demand, or sign up for one of our live events with Q&A.

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Latest Intel

Defining problems using the new 2021 office visit guidelines

The AMA has developed specific definitions for … Read More...

Chronic Care Management

•  Medicare covers chronic care management … Read More...

Essential documentation for medication management and psychotherapy

When providing both medication management and … Read More...

Insights: Changes in level of service using 2021 office visit guidelines

The American Medical Association (AMA) changed the … Read More...

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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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