primary care Archives

Lesion Destruction Tip Sheet

CPT® does not make it easy to locate codes for destruction of lesion(s). These codes are found in multiple chapters throughout the CPT® book, and are … [Read more...]

Reference Sheet for Billing Preventive Medicine Services and Problem Visit

This cheat sheet provides guidance for billing preventive medicine services and split visits. When can you bill for both an office visit AND a … [Read more...]

Can we give a flu shot if the doctor isn’t in the office?

Question: Do we need to have a physician in the office when our clinical staff gives flu shots? Answer: No. CMS allows flu shots to be given … [Read more...]

Anticoagulation Management

I continue to get questions about billing for anticoagulation management, and I’m hoping this post can put some (all?) of them to rest. First, two … [Read more...]

E/M frequency data for family medicine and internal medicine

CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. The panel for family … [Read more...]

Screening codes guide – G0442, G0443, G0444, G0446, G0447

Medicare pays for some screening services for its beneficiaries, using HCPCS codes. These screening codes are time-based HCPCS codes with … [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...]

Repair (closure) CPT^® 12001–13160–2020 update

Laceration or wound repair codes are reported based on the type of repair (simple, intermediate, complex), the anatomic location, and the length … [Read more...]

Modifier 51 or 59? How to know which to bill?

There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter. Appending the correct … [Read more...]

Diagnosis coding for biopsy sent for pathology

Question: What diagnosis code should you use when sending a skin biopsy to pathology? a) D48.5 Neoplasm of uncertain behavior of skin, or b) … [Read more...]

Coding for destruction of malignant lesions

The primary factors in selecting a code for destruction of malignant lesions are: Size of lesion (not defect) Location Method is not a … [Read more...]

CPT® codes for fine needle aspiration

Fine needle aspiration biopsy Material is aspirated with a fine needle and the cells are examined cytologically Core needle biopsy is … [Read more...]

Codes for skin biopsies

CPT updated certain skin biopsy codes in 2019 The codes for excision of benign and malignant lesions did not change, and codes for shave biopsies … [Read more...]

Coding for hypertension in the HCC system | Cheatsheet

Coding for hypertension in the HCC system often requires additional codes to specify type of hypertension, and other complications or factors. This … [Read more...]

Behavioral Health Integration and CCM codes | Cheatsheet

This updated quick reference sheet includes the description for Behavioral Health Integration and CCM codes codes, time requirements, reimbursement … [Read more...]

Using Modifier 59 | Cheat Sheet

Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick … [Read more...]

Using Modifier 33 | Cheat Sheet

Modifier 33 is a CPT modifier used to identify medical care whose primary purpose is delivery of an evidence based service, based on recommendations … [Read more...]

Using Modifier 25 | Cheat Sheet

Use of Modifier 25 may be applicable when an E/M service is provided on the same day as a procedure, a preventive medicine service, or other medical … [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...]