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...]
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.
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...]
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
Coding for Pessary Services Primary care practices, gynecology and urology practices often prescribe and provide pessaries. A pessary is used to … [Read more...]
Billing for Multiple Surgical Procedures
When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and … [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...]
Modifier 95, 93: telemedicine
CPT has two modifiers for telemedicine. Modifier 95 was an existing modifier from before the public health emergency. They added modifier 93 for … [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...]
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!
When we first implemented ICD-10, we 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 … [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...]
Coding for Screening Colonoscopy
An Overview of Colonoscopy Coding Guidelines A screening colonoscopy should have no patient due amount for an insured patient, but if the … [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...]