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...]
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...]
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...]
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...]
Smoking cessation coding, 99406 and 99407
Medicare and most private insurers pay for physicians, NPs and PAs to counsel patients about stopping tobacco use. Medicare waives the … [Read more...]
Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442
The USPSTF recommends screening for alcohol misuse and behavioral interventions for individuals whose screening results are positive. Medicare pays … [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...]
CPT® code 99483: Cognitive assessment and care plan services
Definition of CPT® code 99483 99483: Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in … [Read more...]
Psychiatric Collaborative Care Management Services 99492, 99493, 99494
Care Management for Behavioral Health Definition Services provided under the direction of a treating physician/NP/PA for work performed by a … [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...]
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...]
Primary care and post-op reporting | Medicare requirements
Hey, primary care! This one’s for you too. Primary care doctors probably didn’t pay attention when the news broke that CMS is requiring reporting … [Read more...]
Pessary Billing and Coding
Pessary Insertion CPT® Code & Pessary Cleaning CPT® Code Overview Primary care practices, gynecology and urology practices often prescribe and … [Read more...]
Collaboration of Care Model for Behavioral Health Integration (CoCM.BHI)
Definition HCPCS codes that describe collaboration of care services in primary care practices for patients with behavioral health … [Read more...]
Care Management for Behavioral Health Conditions
Care Management for Behavioral Health Conditions Overview CMS developed HCPCS G0507 code for care management performed by clinical staff for … [Read more...]
New Revenue Opportunities for Primary Care in 2017
2017 brings primary care new revenue opportunities when providing care coordination services, including non-face-to-face prolonged services. There are … [Read more...]
Teaching Physician – Primary Care Exception
Overview | Primary Care Exception and modifier GE CMS updated the teaching physician rules in 2019, and this article reflects the change. On April … [Read more...]
Performing services that increase primary care revenue
CMS states it wants to increase pay to primary care physicians. And while we might quarrel with their strategies or with the speed of achieving the … [Read more...]