Proposed Physician Fee Schedule Rule, 2024 CMS issued the Proposed Physician Fee Schedule (PFS) Rule July 13, 2023, with a 60-day comment period. … [Read more...]
Search Results for: critical care
As Time Goes By
One of the complexities for medical practices is using time in CPT® coding. CPT® has long had a unit of time rule that a unit of time is met when the … [Read more...]
Coding Guide – Teaching Physician Rules
The teaching physician rules are Medicare rules that allow for payment for services that are performed jointly between a resident and a licensed … [Read more...]
Remote Therapeutic Monitoring
There are five remote therapeutic monitoring codes in the general medicine section of CPT® which may be performed by physicians, PAs and NPs and other … [Read more...]
Physician Fee Schedule Final Rule for Calendar Year 2023
2024 conversion factor $32.7442 (updated 1/3/2024) 2023 conversion factor $33.8872 (updated 1/5/2023) CMS continues to state it doesn't have … [Read more...]
Specialty resources
Coding for every specialty is different. For some specialties, you'll find the in-depth knowledge and specific coding information you need to … [Read more...]
E/M Services
For many practices, E/M services are what you do the most. Knowing what type of service to bill, what level of service and the rules related to the … [Read more...]
Coding Guide – E/M Services
This coding guide will describe the guidelines for evaluation and management (E/M) services reported in the office or outpatient department, … [Read more...]
Transferring a Sick Baby to Another Hospital
Question: Our pediatric group practices in a community hospital, without an NICU. My pediatrician was called to attend a delivery of a newborn who … [Read more...]
Physician Specialty Codes and Claims Processing
Specialty designation is determines how claims are processed for physician and non-physician practitioners in groups It is also important in … [Read more...]
Screening Codes Guide – G0442, G0443, G0444, G0446, G0447
Medicare pays for some screening services for its beneficiaries, using HCPCS codes. These screening codes are time-based HCPCS codes with relatively … [Read more...]
Using Time to Select a Code | Dermatology
Some Evaluation and Management codes, and some other codes are defined by the amount of time of the service. This article reflects the rules for using … [Read more...]
Coding for Hospitalists
The information in this post applies to services provided PRIOR TO 1/1/2023 Coding for services done by hospitalists and other specialty physicians … [Read more...]
Coding Guide – Behavioral Health Services
This guide will discuss CPT® coding for behavioral health services. It includes services performed by therapists, psychiatrists and psychiatric nurse … [Read more...]
Coding Guide – Preventive Medicine Services
Cut through the confusion about preventive medicine, wellness visits, adding a problem-oriented visit and the new HCPCS prolonged services codes for … [Read more...]
Coding Guide – Minor Surgical Procedures
This guide is taken from our webinar “Coding for Minor Surgical Procedures”. Medical practitioners often find it easier to do a minor procedure than … [Read more...]
Time Based Rules | Behavioral Health Services
Psychiatrists, psychiatric NPs and psychiatric PAs provide medication management using E/M codes and psychotherapy services. There are specific rules … [Read more...]
Who is Responsible for Coding Physician Services? The Medical Provider or the Coder?
Legally, when a physician, physician assistant (PA) or nurse practitioner (NP) enroll in a Medicare, Medicaid or commercial insurance, the … [Read more...]
CPT® Coding Changes
2023 For a summary of this year's CPT® coding changes download the handout and watch the webinar here. We provide a review of CPT® and CMS changes … [Read more...]
New CPT® Codes for 2018 | Anticoagulation Management and Education for Home INR Monitoring
CPT developed (and Medicare recognizes) two new codes for services related to home and outpatient international normalized ratio (INR) monitoring … [Read more...]
7 Sure Fire Ways to Owe the Government $4 million in Fines and Repayments | Coding Compliance
Most practices aren’t looking to pay the government any money in fines and repayment because of coding errors. Two recent OIG settlements described … [Read more...]