Everyday Coding is Betsy’s signature course. We’ve gathered all the components here in one convenient spot. You can work through them one at a time, select just the ones you need, or customize training for your physicians and staff.
How Fees are Set in the Medicare Fee Schedule
How does Medicare set its fees? This is important for other payers because commercial payers often use the values set by Medicare to calculate their fees. This overview provides information and examples to explain how fees are set in the Medicare Fee Schedule. CodingIntel members can start with the brief video introduction and companion slides, […]
Care Plan Oversight | Coding reference sheet
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182). The requirements for each are different, including time thresholds and what activities may be included in the CPO time. RVUs are assigned by Medicare for these CPT® codes. Some have a bundled indicator and some invalid, which means […]
Advanced Primary Care Management Codes | Webinar
Recorded January 16th, 2025
CMS developed three HCPCS codes effective 1-1-2025 to pay primary care practices to manage the care of patients over time. CMS continues to believe that practices incur significant expense for the care that happens in between office visits.
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.
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!
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