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...]
Search Results for: diagnosis coding
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...]
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 for Skin Cancer
Dermatologists frequently see patients for skin checks, to examine their skin for signs of pre-malignant or malignant lesions. Some of these patients … [Read more...]
Overview of Medicare Telehealth Services
Please see the Telemedicine article for the rules and guidelines for use during the COVID-19 public health emergency. Medicare covers some … [Read more...]
Pre-operative Clearance in Primary Care
Primary care practices are frequently asked to do preoperative evaluations or clearances on their own patients by a surgeon. Although a routine … [Read more...]
Use of Modifier 58 for Dermatology
The most common use of modifier 58 in dermatology is for re-excision of a lesion because the margins weren’t clear, based on the pathology … [Read more...]
E/M for Dermatology | History, Exam, MDM
Accurately documenting and coding E/M services is critical to reducing compliance risk and maximizing revenue for the evaluation and management … [Read more...]
Modifier 25 for Dermatology
Modifier 25 Significant, separately identifiable E /M service by the same physician on the same day of the procedure or other service Use to … [Read more...]
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 … [Read more...]
Intensive Behavioral Counseling for Cardiovascular Disease, HCPCS Code G0446
Medicare pays a primary care physician or other primary care practitioner in a primary care setting to annually provide one face-to-face behavioral … [Read more...]
Behavioral Counseling for Obesity, HCPCS Code G0447
G0447 face-to-face behavioral counseling for obesity, 15 minutes G0473 Face-to-face hehavioral counseling for obesity, group (2-10) 30 … [Read more...]
Emergency Department Visits
Definition Emergency department (ED) services are E/M services provided to patients in the Emergency Department. Explanation These services … [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...]
What Does the Decision to Perform a Minor Procedure Really Mean?
This article is updated with CPT's March 2023 document, "Reporting CPT Modifier 25." (citation at the end of the article) The CPT article adds … [Read more...]
Denial Management Strategies
On-demand webinar Medical practices can decrease denials and accelerate payments by setting up work processes that use advance functions in their … [Read more...]
CPT® Code 99483: Cognitive Assessment and Care Plan Services
Developed in 2018, this service describes an in-depth assessment and development of care plan services for new or established patients who have signs … [Read more...]
Destruction of Benign or Pre-Malignant Lesions
Finding the right code for lesion destruction is not easy. The codes are distributed in the CPT® book in the integumentary, digestive, male genital … [Read more...]
Screening Pelvic/Breast Exam and Pap Smear Denials | G0101 and Q0091
HCPCS codes and Q0091 We received this question from one of our members: "We have a Medicare patient for whom we provided a pelvic and a breast … [Read more...]
Reporting a Problem-Oriented Visit on the Same Day as Welcome to Medicare (G0402) or Initial and Subsequent Wellness Visit (G0438, G0439)
I continue to hear that some consultants and coders don't agree with reporting a problem oriented visit with welcome to Medicare or wellness visit … [Read more...]
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