Some of you have read my article on coding for screening colonoscopy. The questions I get about that article are all related to diagnosis coding. The … [Read more...]
Search Results for: modifiers
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...]
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 … [Read more...]
Coding for Biopsy | Should We Wait for a Pathology Report?
Question: Should we always wait for the pathology report before submitting a code for a biopsy? Answer: Sometimes. Wait for the pathology … [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...]
Billing Physician Services for Hospice Patients | Reference Sheet
Medical practices find the hospice modifiers confusing, and confusion leads to denials and payment delays. Use the decision trees below to help you … [Read more...]
Billing Medical Practice Services for Patients on Hospice
Overview of hospice care Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their … [Read more...]
Can Two Practices Split the Post-Op Office Care of a Patient?
Question: Can two practices split the post-op office care of a patient? Answer: No. Although the operative and post-operative portions of 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...]
Do I Need Modifier 52 for this Repair?
Question: Can you please give me your opinion on a coding case? We have a surgical oncologist that performed an excision of malignant skin … [Read more...]
Selecting CPT® Rules for Excision of Skin Lesions
Many medical practices perform skin procedures. A patient may see a dermatologist, a family physician or a surgeon when the time comes to find out, … [Read more...]
Avoid These 4 Costly Errors When Coding Minor Surgical Procedures
Does your practice perform any minor or major procedures? If so, this post is for you! Primary care practices and urgent care centers should pay … [Read more...]
Everything You Want (And Need) to Know About E/M Services
Evaluation and Management (E/M) services account for 30% of the revenue paid by Medicare for all physician services. For many specialties, E/M codes … [Read more...]
CMS is Seeking Comments About Updating E/M Service Definitions
I hope you’re sitting down, because there is big news! The proposed physician fee schedule rule was released in mid July and includes a section about … [Read more...]
Reporting Excision of Multiple Lesions of the Same Size
Question: The doctor I work with excised two benign lesions from a patient’s arm, of the same length. Do I add them together and report one code? … [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...]
Co-Surgery, Team Surgery, Assistant at Surgery
Modifiers for co-surgery, team surgery and assistant at surgery CPT® has specific modifiers for co-surgery, team surgery and assistant at surgery. … [Read more...]
Billing for Multiple Surgical Procedures
When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and … [Read more...]
Global Post-Op Reporting
Coding. Why does is keep changing? This post was out of date and has been removed. For information about the global surgical package and … [Read more...]
Modifier 95, 93: Telemedicine
CPT has two modifiers for telemedicine. Modifier 95 was an existing modifier from before the public health emergency. They added modifier 93 for … [Read more...]
Modifier 57
Decision for Surgery. An evaluation and management service that resulted in the initial decision to perform surgery may be identified by adding … [Read more...]