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...]
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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...]
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...]
Time: Using Time for Office Visits
Using time to select a level of service for office visit codes 99202—99215 Total practitioner time on the date of service can be used to select … [Read more...]
New E/M Rules Effective Date and Payer Policies
Question: When can we start using the new E/M rules for new and established patient visits? And, are all payers going to follow … [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...]
New Versus established Patient Visits
There are other articles on CodingIntel about the difference between new and established patients, and the rules haven’t changed, but that doesn’t … [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...]
Coding Inpatient Pediatric Services | Webinar
Recorded May 23, 2019 NOTE: This webinar contains observation services that are deleted effective 1-1-2023. Observation is reported with codes … [Read more...]
Anticoagulation Management
Currently, there are two sets of codes, three HCPCS codes and two CPT® codes. They aren’t defined exactly the same, and so take careful reading. The … [Read more...]
ROS Requirements for Preventive Services OB/GYN
Question: What are the review of system requirements when an annual physical (99381-99387, 99391-99397) is performed/billed by an OBGYN … [Read more...]
E/M in 2019: A Look Ahead
Now that the dust has settled from the release of the Physician Fee Schedule Final Rule, maybe it’s time for a re-cap. This article will also discuss … [Read more...]
Anticoagulation Management | Can We Bill for RN Services?
Question: My question is regarding Anticoagulation Management Code 93793. Guidelines state that this code can be performed by a physician, NP, or … [Read more...]
Remote Physiologic Monitoring Treatment Management Services
This is an overview of coding for Digitally Stored Data Services/Remote Physiologic Monitoring in the E/M section of the CPT book. There are more … [Read more...]
The CodingIntel Guide to HCC Coding
Hierarchical Condition Categories (HCC) is a coding system developed by Medicare to pay Medicare Advantage insurance companies, based on demographics … [Read more...]
Care Management in Primary Care Practices | Webinar
Recorded September 20, 2018 @ 12:00 pm (EST) Primary care practices can be reimbursed for the non-face-to-face work of caring for chronically ill … [Read more...]
Are Start and Stop Times Required for Non Face-to-Face Prolonged Care Services?
Question: Regarding non face-to-face prolonged care, does Medicare require start and stop times, they way they do for prolonged face-to-face care? … [Read more...]
Wellness Visits and Care Management in Rural Health Centers and Federally Qualified Health Centers (RHCs and FQHCs)
RHCs and FQHCs are paid an all-inclusive rate (AIR) or national prospective payment system (PPS) rate for any service that is defined as a visit to … [Read more...]
Dear Resident, Do you Understand Relative Value Units (RVUs)?
Measuring physician productivity with work RVUs: News flash! Physicians are more interested in medicine than coding. No doctor undertook the … [Read more...]
Prolonged Services and Nursing Home Visits
Question: Prolonged Services and nursing home visits. I'm getting a "Code 99358 is a column 2 code for 99309, these codes cannot be billed … [Read more...]
General Behavioral Health Integration Care Management
99484 Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other … [Read more...]