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May 23, 2025

CPT® Coding Changes

Updates to the CPT® Manual: 2025 Edition The 2025 edition of the CPT® Manual confirms hundreds of code changes that take effect Jan. 1, 2025, including 270 new codes and 112 deleted codes. The 2025 Manual also revises nearly 40 codes. In this roundup of some of the significant changes to the 2025 CPT code […]

Annual CPT® Changes | Webinar

Recorded December 19th, 2024

Guest presenter Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O

Each year the American Medical Association releases updates to the CPT® Manual. This year’s release contains 420 updates including 270 new codes, 112 deletions and 38 revisions that will be effective 1-1-2025.

ICD-10-CM Chapter Specific Guidelines – Chapters 17–20

The ICD-10-CM Official Guidelines for Coding and Reporting sets the precedent of rules that all diagnostic coders must abide by. Section I.C. covers the chapter-specific guidelines. These offer detailed information about various conditions that require more thorough reporting guidance than the general guidelines provide. Reading the guidelines in their entirety is incredibly important, but this […]

ICD-10-CM Chapter Specific Guidelines – Chapters 14–16

The ICD-10-CM Official Guidelines for Coding and Reporting sets the precedent of rules that all diagnostic coders must abide by. Section I.C. covers the chapter-specific guidelines. These offer detailed information about various conditions that require more thorough reporting guidance than the general guidelines provide. Reading the guidelines in their entirety is incredibly important, but this […]

ICD-10-CM Chapter Specific Guidelines – Chapters 11–13

The ICD-10-CM Official Guidelines for Coding and Reporting sets the precedent of rules that all diagnostic coders must abide by. Section I.C. covers the chapter-specific guidelines. These offer detailed information about various conditions that require more thorough reporting guidance than the general guidelines provide. Reading the guidelines in their entirety is incredibly important, but this […]

CMS’s Physician Fee Schedule Final Rule

Recorded December 10th, 2024

Guest presenter Claire Ernst, Director, Government Relations & Public Policy for Hooper, Lundy & Bookman, P.C.

The 2025 Physician Fee Schedule rule, released in early November, includes policy changes for physician practices effective January 1st. This year, CMS proposed over 20 new HCPCS codes including an inpatient add-on code for infectious disease treatment, additional caregiver training codes, digital mental health treatment (with device), interprofessional consults for behavioral health and ASCVD risk screening.

Smoking Cessation, Substance Use Counseling, Screening, and Intervention Coding, 99406-99609

Although the use of tobacco products is on the decline in the United States, the consumption of alcohol and other addictive substances remains a common preventable problem. As a result, the American Medical Association’s (AMA’s) CPT Editorial Panel included a spotlight on reporting tobacco, alcohol, and substance use cessation, counseling, screening, and intervention codes in […]

DRG Red Flags: A Payor Perspective | Webinar

Recorded November 21st, 2024

Guest Presenter Dr. Amarin “Ty” Alexander, MD MBA MA, CHCQM-PHYADV, CPC-A, CIC, CRC, CPMA, CDIP, CDEI

Inpatient coding for DRGs is based on diagnosis coding. Some coding summaries can raise red flags with payers, even before looking at the medical record documentation. This webinar will detail what Present on Admission (POA) conditions invite scrutiny, why a short Length of Stay (LOS) with one Major Complication and Comorbidity (MCC) might raise a red flag and why payers will review malignancy as a secondary diagnosis.

ICD-10-CM Chapter Specific Guidelines – Chapters 7–10

Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]

ICD-10-CM Chapter Specific Guidelines – Chapters 4–6

Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]

ICD-10-CM Chapter Specific Guidelines – Chapters 1–3

Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]

FAQ: Scoring Elements in the E/M Guidelines

Scoring MDM elements can be challenging for E/M services This post includes questions related to: Major/Minor procedure Data Elements (with link to additional resources) General questions about the guidelines Using time (with link to additional resources) Social determinants of health Major or minor procedure? Question: I have a question about how to determine if a […]

Consent for Communication Technology-Based Services (CTBS)

Both CPT and CMS have developed codes for non-face-to-face communication-based technology services in recent years. In addition to care management services, these include interprofessional consults, remote physiologic and therapeutic monitoring, and on-line digital E/M services In the 2020 Physician Fee Schedule Final Rule, CMS clarified the type of patient consent that is required to perform […]

Remote Therapeutic Monitoring

There are six remote therapeutic monitoring codes in the general medicine section of CPT® which may be performed by physicians, PAs and NPs and other practitioners such as psychologists, LCSWs, physical therapists and occupational therapists These codes are for non-physiologic measures and the results can be uploaded digitally or reported by the patient A physician, […]

Remote Physiologic Monitoring Treatment Management Services

This is an overview of coding for Digitally Stored Data Services/Remote Physiologic Monitoring in the E/M section of the CPT book. There are more detailed articles for the individual codes on CodingIntel. Put the code in the search box to find them. Medical practices can use these devices to monitor a patient’s health metrics, assess […]

Blood Pressure Self-Measurement: Education, Training and Analysis | CPT® Codes 99473, 99474

There are two CPT® codes specifically for blood pressure self-measurement and management. The first is for patient education and calibration of a home blood pressure device The second is for reviewing data collected by the patient at home, with a report and communication back to the patient 99473  Self-measured blood pressure using a device validated […]

ICD-10-CM Conventions, Structure, and Format: Section I.B

The first step to finding the most accurate code is to confirm that you are working with the correct version of the ICD-10-CM Official Guidelines for Coding and Reporting. The correct version may be the most recent update, or – in the context of retrospective coding– it may need to be a previous version that […]

Transforming Patient Collections: Expert Insights and Strategies | Webinar

Recorded October 16th, 2024

Guest Presenter Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC

Gain valuable insights on how to effectively respond to industry changes and actionable steps to enhance your revenue cycle management. Join Elizabeth for an engaging and informative webinar centered around navigating the current inflection point in patient collections. Patient financial responsibility is increasing – and it’s time for you to rise to the challenge!

Compliance Guide

You may have heard about the “Seven Elements for an Effective Compliance Plan.” In fact, if you enter that term in a popular web browser “about 575,000” results appear within seconds. Fortunately, compliance and enforcement agencies endorse the elements and provide great examples on what to do – without having to delve much into those […]

Where Does it Say That? | Webinar

Recorded October 9th, 2024

Guest Presenter Pam Warren, MHA, COC, CPC, Fellow

This webinar is a guide for auditors and coders looking for regulatory guidance when they are answering coding, compliance and regulatory questions from practitioners and colleagues. This presentation offers common healthcare compliance scenarios and provides the location of the associated guidance.

CMS Implemented G2211 in 2024

CMS releases G2211 FAQ: Finally! Eight months after implementing G2211 CMS has released a FAQ document answering questions they’ve received via email and during Open Door Forums. The link is below. Some of the document reiterates information from the Federal Register and MLN Matters article, and some is new. G2211 Visit complexity inherent to evaluation […]

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Annual CPT® Changes Webinar

CodingIntel welcomes back Shannon McCall of HCPro for this review of changes that will go into effect January 1st, 2025. Exclusively for members.

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Compliance for Medical Practices

Exclusively for members, this two module concentration includes guidance for developing an audit workplan, and how to locate source citations for common healthcare compliance scenarios.

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IRE Inpatient Determinations: Case Studiesoding for Prolonged Services | Webinar

Exclusively for members, this case-study focused webinar describes important ICD-10-CM Guidelines that establish the rules for these decisions.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

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.

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