Some modifier errors are easily avoided by experienced coders or practice management software with an editing function to stop incorrect claims before … [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.
Every claim line tells a story | CPT® Modifiers
Some people read mystery novels, some people can read body language but medical coders can read claims. Some claim lines are simple to read. The … [Read more...]
Skin Test for Tuberculosis (PPD)
How do we bill for placing the skin test for tuberculosis? To bill for placing the purified protein derivative (PPD) skin test for tuberculosis, use … [Read more...]
Pessary Billing and Coding
Pessary Insertion CPT® Code & Pessary Cleaning CPT® Code Overview Primary care practices, gynecology and urology practices often prescribe and … [Read more...]
My payer doesn’t follow CPT® rules. What am I to do?
Why Are Medical Claims Denied? Most medical claim denials in practices aren’t related to coding. Medical claims are most frequently denied because … [Read more...]
Billing for Multiple Surgical Procedures
Multiple procedures on the same day. Use this step by step procedure to determine if you should bill for more than one procedure, and if so, if you … [Read more...]
Facility versus Non-Facility in the Physician Fee Schedule
CMS develops and publishes the Physician Fee Schedule in November of each year, as part of the Physician Fee Schedule Final Rule The fee schedule … [Read more...]
This practice paid Medicare $4.48 million
Do you sign up for email lists and then wonder why you did it? We all do, don’t we? But, one email I always read is from the Department of Justice … [Read more...]
Psychotherapy coding changes 2017
Words removed from one set of codes, time added to another code. There are two changes in the psychiatry section of CPT® for 2017 behavioral health … [Read more...]
End Confusion About Modifier 57 (and get paid for initial evaluations)
Use modifier -57 at the visit for the decision for surgery, when surgery is scheduled for that day or the next calendar day A surgeon should always … [Read more...]
Not billing consult codes? You are losing $$$$
In 2010, Medicare stopped recognizing consultation codes. In their discussion, they stated that they still did pay for consultations, but they used … [Read more...]
Performing services that increase primary care revenue
CMS states it wants to increase pay to primary care physicians. And while we might quarrel with their strategies or with the speed of achieving the … [Read more...]
Overview of advance care planning
Advance Care Planning CPT® Codes Overview Primary care practices perform countless tasks every day for which there is no payment. CMS continually … [Read more...]
Pecked by a parrot. Oh no, not again!
We’ve all had a lot of fun with the ICD-10-CM external cause codes. But, do we need to use them? The answer to that is no according to the official … [Read more...]
Prescription drug management and medical decision making (MDM)
Whether using the original 1995/1997 guidelines or the 2021 new office/outpatient code guidelines for selecting the level of E/M service, the question … [Read more...]
Skype ≠ Telemedicine
I got a call from a vendor trying to develop a video conferencing product for a physician to use to talk to a patient who is at home. He said “I’m … [Read more...]
Risky business, or tempest in a teapot: Are you an audit target?
Some days, it appears we compliance and coding folks are like the boy who cried wolf. We see shadows around every corner. We emulate Captain Kirk, … [Read more...]
Your Patient Wants to Talk: How to Bill for Discussion Visits
The current CPT rules for office visits say time may be used to select a code for new or established patients if counseling/coordination of care … [Read more...]
Coding for Screening Colonoscopy
An Overview of Colonoscopy Coding Guidelines Screening colonoscopy is a service with first dollar coverage. A screening test with an A or B rating … [Read more...]
No Chart Left Behind: Deadline to Complete Medical Records
Years ago, I worked with a physician who was chronically behind in dictating his notes. The charts were crammed into boxes by date, lining the walls … [Read more...]