This article covers CPT® and diagnosis codes used for screening for other sexually transmitted illnesses. It includes descriptions and screening criteria. To tell whether or not you can collect a co-pay for the testing or not can be found on the U.S. Preventive Services Task Force (USPTF) website [1]. The Affordable Care Act mandated that […]
Coding Guide – Teaching Physician Rules
The teaching physician guidelines are Medicare rules that allow for payment for services that are performed jointly between a resident and a licensed attending physician (the teaching physician). This downloadable coding guide from CodingIntel provides an explanation of teaching physician rules for E/M services and specialty specific services.
Billing Medical Practice Services for Patients on Hospice
Overview of Hospice Care Additional Services (non-Hospice Organization) Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their end-of-life care provided by a hospice organization (the “hospice”). Medicare then pays hospice to provide all the care that the patient needs that is related to […]
Teaching Physician Rules | Quick Reference Guide
This quick reference guide breaks down who must document what for which services as outlined in Medicare’s teaching physician rules.
Select HCPCS codes from 2025 and 2024 | Webinar
Recorded March 20th, 2025
1 CEU expires 3/30/26
CMS continues to develop new HCPCS codes to describe services that promote their healthcare agenda, and are not in the CPT® code set. This webinar will address a select few of the newer services from this year and last year.
Aftercare and Follow-Up: ICD-10-CM Coding
Aftercare visit codes are assigned in situations in which the initial treatment of a disease has been performed but the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. ICD-10 makes two important points about the use of aftercare codes in the final chapter. The aftercare […]
Overview of FQHC and RHC Coding | Webinar
Recorded February 20th, 2025
1 CEU expires 2/28/26
Federally Qualified Health Centers (FQHCs) operate in rural and urban areas, and provide services to Medicare, Medicaid patients and privately insured patients. Rural Health Centers operate in rural areas and also provide services to Medicare, Medicaid and privately insured patients.
Anatomy of an Audit™
Recorded February 4th, 2025
2 CEUs expire 2/28/26
Guest presenters Pam D’Apuzzo and Debra Rossi of VMG Health, and Pam Warren of MaineHealth
These two sessions take a deep dive into the audit process. Session one focuses on E/M Services, and session two, Surgical Procedures & Diagnostic Tests.
National Coverage Determination: PrEP for HIV Prevention | HCPCS Code G0011
Physicians and qualified health professionals (QHP) can gain reimbursement for up to eight counseling sessions per year for HIV risk assessment, risk reduction and medication adherence, according to a recently issued national coverage determination (NCD). Background On September 30, CMS issued a NCD 210.15, Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention, which shifts […]
Everyday Coding for Medical Practices
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
1 CEU expires 1/30/26
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
1 CEU expires 12/30/25
Guest presenter Shannon of HCPro
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
1 CEU expires 12/30/25
Guest presenter Claire Ernst
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. Join us to learn which of these proposed services will be implemented in 2025.
DRG Red Flags: A Payor Perspective | Webinar
Recorded November 21st, 2024
1 CEU expires 11/30/25
Guest Presenter Dr. Amarin “Ty” Alexander
Inpatient DRG coding is based on diagnosis coding. Learn how payers use coding summaries. This webinar describes Present on Admission (POA) conditions that invite scrutiny and why short Length of Stay (LOS) with one Major Complication and Comorbidity (MCC) might raise red flags.
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 […]
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