This aricle reviews the codes and guidelines for these dermatologic procedures; Intralesional injections, photodynamic therapy, phototherapy, and laser treatments. Intralesional injections Intralesional injections deliver a medication directly into a specific skin lesion, allowing the medication to be delivered over a period of time. Corticosteroids are common examples. Report either code 11900 for up to 7 […]
Modifier 51 or 59? How to Know Which to Bill?
Modifier 51 and 59 are both used on second and subsequent surgical procedures, when performed on the day of a primary procedure See also Modifier 59 quick reference sheet There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter. Appending the correct modifier increases the likelihood […]
Shaving of Epidermal or Dermal Lesions
The chart below includes CPT® codes, and descriptions for shaving epidermal and dermal lesions. After the chart, there are important key points to keep in mind when using these codes. Code Description 11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less 11301    lesion diameter […]
Quick Coding Reference Sheet – Hospitalists
This quick coding reference sheet is a must have when coding E/M services for hospitalists. It covers consults, initial and subsequent hospital visits, and observation.
Quick Coding Reference Sheet – Dermatology
This dermatology specific E/M reference sheet includes 1997 single specialty skin exam and medical decision making examples relevant to your specialty. A must have reference for physicians and staff coding for dermatology services!
Coding for Destruction of Malignant Lesions
The primary factors in selecting a code for destruction of malignant lesions are: Size of lesion (not defect) Location Method is not a factor in code selection Per Principles of CPT® Coding: “The destruction of malignant lesions is reported with codes 17260—17286. Similar to the codes for excision of lesions, the correct code is chosen […]
Virtual Communication: HCPCS Codes G2010, G2250, G2251, G2252; CPT® 98016
Virtual communications are not considered telehealth These HCPCS codes were developed by CMS for virtual communication They are not on CMS’s list of telehealth services and do not use real-time, interactive, audio/visual communication They do require verbal consent; a single consent can be obtained for all communications based technology services annually for Medicare patients In […]
Checklist for CPT® code 99483 | cognitive assessment code for dementia
Is your practice performing cognitive assessments for patients with dementia, using CPT® code 99483? If so, use this checklist to make sure you have documented all of the required components.
CPT® Codes for Fine Needle Aspiration
Fine needle aspiration biopsy Material is aspirated with a fine needle and the cells are examined cytologically Core needle biopsy is performed with a larger bore needle to obtain a core sample Use code 10021 for FNA without imaging guidance, first lesion and 10004 for each additional lesions There are codes for FNA include imaging […]
Skin Biopsies
Correctly selecting and reporting skin biopsies requires an understanding of CPT® codes for skin biopsies There are codes for excision of benign and malignant lesions, and codes for shave procedures. Those are coded based on the size of the excision and location There are specific biopsy codes in other chapters, for biopsy of ears, lips, […]
Coding for Diabetes in the HCC System | Reference Sheet
This quick reference sheet simplifies coding for diabetes in the HCC system. A must-have resource for clinicians who see patients with diabetes.
Coding for Hypertension in the HCC System | Reference Sheet
This quick reference sheet simplifies coding for hypertension in the HCC system. A must-have resource for clinicians who see patients with hypertension.
Coding Guide – Behavioral Health Services
The coding for psychiatric and psychotherapy services changed in 2013 and although that was years ago many psychiatrists, psychiatric nurse practitioners (NPs), and psychiatric physician assistants (PAs) are still adjusting to the change. This guide will answer questions about how to code for behavioral health services including: initial evaluations, re-evaluations, medication management, and psychotherapy.
Coding Guide – Medicare Incident-to and Shared Services
This in depth guide reviews the requirements for billing Medicare Incident-to and shared services including: when/where these services can be billed, which provider number to use, and documentation requirements.
Behavioral Counseling for Obesity, HCPCS Code G0447
G0447 face-to-face behavioral counseling for obesity, 15 minutes G0473 Face-to-face behavioral counseling for obesity, group (2-10) 30 minutes Medicare pays for ongoing face-to-face behavioral counseling for patients with a body mass index (BMI) of ≥ 30, who are alert and able to participate in counseling. The service may be performed by a physician or non-physician […]
Coding Guide – Minor Surgical Procedures
This guide includes definitions of minor procedures used frequently in primary care and urgent care. And, even more important, instructions for billing the services. No minor procedure guide would be complete without a discussion of modifier 25. It is also the reference for CodingIntel’s minor procedures webinar which you can watch here.
Emergency Department Visits
Definition Emergency department (ED) services are E/M services provided to patients in the Emergency Department. Explanation These services may be billed by any specialty physician, not just Emergency Department physicians. The physician does not need to be assigned to the ED. However, these codes may only be used in a hospital-based facility that is available […]
Advance Care Planning | CPT® 99497, 99498 Video
Advance Care Planning (ACP) 99497 Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health professional; first 30 minutes, face- to-face with the patient, family member(s) and/or surrogate); +99498Â Â Â Â Â Â Â each […]
Exam | Documentation Guidelines for E/M Services
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong….) However, we will still need to use them when auditing notes from before 2023. This article does not apply to services performed after 1-1-2023. Definition Exam is one of the three key components (history, exam and medical decision making) of Evaluation and Management Services. […]
Using Time to Select a Level of E/M Service
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong….) However we will still need to use them when auditing notes from before 2023. This article does not apply to services performed after 1-1-2023. Remember, don’t use the information in this article for current services. Use these rules when billing for codes that use […]
Diagnosis Coding | Not Just for Claims Anymore
Physician claims are paid based on the fee schedule associated with the CPT® or HCPCS code that is submitted. Diagnosis coding can be a reason for a denial. Physicians use CPT® or HCPCS codes to tell the payer what was done (colonoscopy, office visit) and modifiers to describe special circumstances (assistant at surgery, bilateral procedure.) […]
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