Ready to learn about the 2023 CPT® E/M changes? There is a significant update to the Evaluation and Management (E/M) section of the CPT® book. There … [Read more...]
Search Results for: medical decision making
Behavioral Health Coding Compliance
Once again, with feeling: coding for behavioral health It's been a year (seems like a minute) since the OIG released a report on coding for … [Read more...]
Does a Practitioner Need to Document Time for a Telehealth Visit?
Question:Â Does a practitioner need to document time for a telehealth visit? What if it is audio only? Answer: First: For a telehealth visit, … [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...]
Why Not Bill All 99213 Visits in an FQHC?
Why not bill all 99213 visits in an FQHC? (Hint: it's a good way of telling everyone that they were pretty easy visits.) Practitioners who work in … [Read more...]
When to Use Time to Select an E/M Service
Selecting a code for an E/M service can be done based on time or MDM (except ED visits which only use MDM) Time includes all time spent by the … [Read more...]
Consultation Codes
First, CMS stopped recognizing consult codes in 2010. Outpatient consultations (99241—99245) and inpatient consultations (99251—99255) were still … [Read more...]
Office Visit Code Selection for Medication Management
At some visits, psychiatrists and psychiatric NPs and PAs provide only medication management, and at some visits, they manage prescriptions and … [Read more...]
Essential Documentation for Medication Management and Psychotherapy
When providing both medication management and psychotherapy, practitioners need to document the time spent in psychotherapy and describe the therapy. … [Read more...]
Documentation Essentials for Codes 99202—99215
The AMA developed new guidelines for office visits in 2021, and then revised them in March, 2021. (That was fast). Are you confident that you are … [Read more...]
Documenting and Coding Observation Services in 2021
For Medicare patients in observation, the consulting physician uses new and established patient visit codes. Only the admitting physician can use … [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...]
Is it or isn’t it a Telehealth Service?
Many payers and practices use the broad term telehealth to describe services that are not done face-to-face with a patient CMs describes telehealth … [Read more...]
The Second Element of MDM: Amount and/or Complexity of Data
There are three elements in medical decision-making and this article describes the second, arguably, the most complex of the three elements When … [Read more...]
The Third Element of MDM: Risk of Complications
The third element of MDM: risk of complications and/or morbidity or mortality of patient management at the encounter Coding for E/M services … [Read more...]
An Overview of the Revised MDM
Medical Decision Making: selecting the correct level of service for codes 99202—99215:  E/M codes 99202—99215 have a changed definition of MDM … [Read more...]
The First Element of MDM: Number and Complexity of Problems Addressed
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 … [Read more...]
E/M rules archive
We're archiving articles related to the E/M guidelines for services provided prior to January 1st, 2023. Though these posts don't apply to services … [Read more...]
E/M Changes in 2021 for 99202-99215 | Overview
It's here! New definitions for codes 99202--99215 Clinicians can select new and established patient visit based on time or medical decision making … [Read more...]
CMS 2020 Proposed Rule Updates
CMS rescinds bundled payments for 2021 and accepts CPT® revisions for new and established patients Proposes new HCPCS codes for care management … [Read more...]
Psychiatric Diagnostic Evaluation
There are two codes for psychiatric diagnostic evaluation. 90791 Psychiatric diagnostic evaluation 90792 Psychiatric diagnostic evaluation with … [Read more...]