Question: A CodingIntel member writes: "I am getting mixed information about incident-to and I was wondering if you could weigh in? If a NPP … [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...]
Coding Guide – Preventive Medicine Services
This is the resource guide from CodingIntel's one hour course on preventive medicine. Coding for preventive medicine services should be easy, but … [Read more...]
Screening for depression | HCPCS code G0444
Annual depression screening code G0444 Medicare pays primary care practices to screen all Medicare patients annually for depression. The service … [Read more...]
Behavioral counseling for obesity, HCPCS code G0447
Medicare pays for ongoing face-to-face behavioral counseling for patients with a BMI of ≥ 30, who are alert and able to participate in … [Read more...]
Preventive Medicine Services – Medicare
Medicare has very specific requirements for preventive services. What can you bill, what must you document? This article covers all the bases … [Read more...]
Are you missing the initial annual wellness visit? | G0438
After I gave a presentation at a family medicine conference a physician said to me, “What you just told me will pay for the entire cost of my coming … [Read more...]
Age and wellness visits | Eligibility for Welcome to Medicare
Question: Does the patient need to be 65 years old in order to bill the Welcome to Medicare Visit? Answer: This is almost a trick question. … [Read more...]
Teaching physician rules | Bedside procedures
Question: Can an attending bill for a bedside procedure that a resident did without the attending being present? If so, is this billed at 85% like … [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...]
Wellness visits and prolonged care | How to use G0513 & G0514
Medicare stunned us by creating two prolonged services HCPCS codes for use with Medicare covered preventive medicine services in 2018. They may be … [Read more...]
Medical necessity isn’t medical decision making
Have you heard of Talk Ten Tuesdays? It’s an internet radio program hosted by Chuck Buck and Dr. Erica Remer, and every week they discuss current … [Read more...]
Let’s go to the source! Should this visit be downcoded?
This article describes the use of time using the 1995/1997 guidelines. Be sure to read about the 2021 guidelines for codes 99202--99215. A … [Read more...]
Screening pelvic/breast exam and pap smear denials | G0101 and Q0091
Updated for 2020 We received this question from one of our members: "We have a medicare patient for whom we provided a pelvic and a breast exam … [Read more...]
Medicare Rules for Incident-to Billing and Shared Services | Webinar
Incident-to services appear on the OIG Work Plan frequently. The stakes are high for the practice in terms of revenue and compliance. Ask around the … [Read more...]
G0101 Pelvic and Breast Exam
Medicare developed two HCPCS codes for screening services for women, without certain frequency time limits G0101(screening breast and pelvic exam) … [Read more...]
Medicare Rules for Incident To and Shared Services
Whose provider number is being used to bill services to the insurer, or to Medicare? This is a compliance risk area often overlooked. This 10 minute … [Read more...]
Non Face-to-Face Prolonged Service – 99358
Codes 99358 and 99359 are used for non-face-to-face prolonged services by the billing physician/NP/PA when provided in relation to an E/M service on … [Read more...]