May 22, 2025
Recorded September 26th, 2024
Guest Presenter Adrienne Commeree, MLS, RHIA, CPC, CPMA, CCS, CEMC, CPIP
The webinar will discuss the FY 2025 ICD-10 -CM code and guidelines updates. We will look at the changes the 2025 ICD-10-CM code book- most will be in the Alphabetic Index and Tabular list.
This article describes the proposed HCPCS codes in the PFS with the proposed payment and highlights for each code set. Coding highlights from the 2025 PFS proposed rule Medicare releases proposed policy changes for medical services for the next year each July, accepts comments on the proposals for 60 days, and sends out the final […]
Recently, while reviewing terms people use to find CodingIntel I was surprised to find that people were searching for “xxxA.” At first, I was afraid searchers were looking for a different kind of site….or sight. But searchers were looking for information about placeholder code X and 7th character extension A. These are typically used on […]
Recorded September 25th, 2024
Guest Presenter Pam Warren, MHA, COC, CPC, Fellow
There are seven elements of an effective Compliance Plan per the OIG, and one of them is to conduct internal monitoring and auditing.
This presentation will give you some ideas on how to determine what content to audit, how to evaluate your risk, how to set up your audit process, and how best to report your results to your leaders.
As you read this article, it will be helpful if you have the ICD-10-CM book in front of you. You can download a pdf copy here. And even if you don’t download the entire book, download the Official Guidelines instead. There are four cooperating parties to ICD-10-CM. They publish and update the official guidelines for […]
E/M elements for MDM There are three elements in medical decision-making and this article describes the first of three When selecting a level of service based on medical decision-making two of the three elements are required CPT® has developed definitions for many of the components in the MDM chart. The examples listed in the definitions […]
The third element of MDM: risk of complications and/or morbidity or mortality of patient management at the encounter Coding for E/M services There are three elements in medical decision-making and this article describes the third, the risk of complications and/or morbidity or mortality related to patient management When selecting a level of service based on […]
There are three elements in medical decision-making and this article describes the second, arguably, the most complex of the three elements When selecting a level of service based on medical decision-making two of the three elements are required CPT® has developed definitions for many of the components in the MDM chart. This article describes the definitions […]
First, CMS stopped recognizing consult codes in 2010. Outpatient consultations (99241—99245) and inpatient consultations (99251—99255) were still active CPT® codes, and depending on where you are in the country, are recognized by a payer two, or many payers. In 2023, codes 99241 and 99251 are deleted. These two low level consult codes were rarely used. […]
Recorded August 15th, 2024
Guest Presenters Cheryl Krusch, LPN, CPC, CPMA, COC, CMDP, ICDCT-CM, and
Natalie Laaman, MHA, CHC, CPC, COC, CDEO
Join us for a comprehensive webinar on assuring compliance for behavioral health services. We will explore essential documentation requirements and coding standards, understand common denial reasons, and learn proactive steps to mitigate risk effectively. Elevate your practice’s compliance standards and ensure proper documentation and coding for revenue integrity
Recorded August 13th, 2024
Guest Presenter Dr. Amarin “Ty” Alexander, MD MBA MA, CHCQM-PHYADV, CPC-A, CIC, CRC, CPMA, CDIP, CDEI
Independent Review Entities review inpatient records for diagnostic accuracy and DRG determinations. This case-study focused webinar will describe important ICD-10-CM Guidelines that establish the rules for these decisions.
CPT codes for observation services Beginning January 1, 2023 there are two sets of codes used for both inpatient status and observation level of care. Coding for observation services no longer has a distinct set of CPT® codes, those were deleted. Use 99221–99223 for initial inpatient or observation care services and use 99231–99233 for inpatient […]
Question: In 2023, how will we code for visits in assisted living? Answer: January 1st 2023, the codes for boarding home, rest home and domiciliary care are gone from the CPT® book. What are the codes for visits in assisted living in 2023 and beyond? Home and residence services (99341—99345 for new patients) and (99347—99350 […]
Question: When using the E/M guidelines, is the problem an an acute, uncomplicated illness or an acute illness with systemic symptoms? Answer: Let’s start with the CPT definitions, from the CPT® Professional edition. Acute, uncomplicated illness Acute illness with systemic symptoms From CPT®: A recent or new short-term problem with low risk of morbidity for […]
Definition and Explanation of Critical Care Service Definition: Coding service for caring for a critically ill or injured patient Explanation: Critical care has high relative value units and payments so it’s important to know the coding rules. This article describes what can be included in the time of critical care what can’t be included, and […]
In 2024, CPT® expanded its definition of split/shared services, CMS updated their requirements. Neither CMS nor CPT made changes tot his policy for 2025. CPT® expanded its definition of split/shared services in 2024, stating that the substantive portion can be determined by the practitioner who spent more than 50% of the time, or who made […]
Recorded July 25th, 2024
CMS released its 2025 Proposed Physician Fee Schedule rule on July 10, and it’s packed with coding policy proposals. The conversion factor is always bad news. But, there is good news too.
Billing for pap smears in a physician practice can be confusing for clinicians and coders alike. Pap smears can be screening services or diagnostic services There is a HCPCS code for obtaining a screening pap smear, Q0091 Performing a pelvic exam is either part of a preventive medicine service or problem oriented visit A new […]
Medicare developed two HCPCS codes for screening services for women, without definitive frequency time limits Both G0101 (screening breast and pelvic exam) and Q0091 (obtaining a screening pap smear) may be billed every two years for a low-risk patient and every year for high-risk patients These are not comprehensive preventive medicine services They may be […]
How is risk evaluated when selecting a level of E/M service? We know that the risk from additional diagnostic testing/procedures and management is one of the three elements that determines the level of service, when MDM is used. But, how about the risk from the condition itself? This short video (I always say they’re short […]
Recorded: June 2024
Guest Presenter Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC
The Centers for Medicare & Medicaid Services have approved five new payment opportunities for 2024 – just the beginning of what promises to be a significant shift in the reimbursement landscape for medical practices.
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