This article will review the codes and guidelines for the following behavioral health screening and testing services: Assessment of Aphasia and Cognitive Performance Testing Developmental And Behavioral Screening and Testing Neurobehavioral status examination Assessment of Aphasia and Cognitive Performance Testing CPT© codes for the assessment of aphasia and cognitive performance testing include: 96105 – Assessment […]
Specialty Pages
Coding for every specialty is different. For some specialties, you’ll find the in-depth knowledge and specific coding information you need to accurately and compliantly submit claims. Whether you prefer reading articles, downloading reference sheets and coding guides or watching a webinar, CodingIntel has what you need.
E/M Frequency Data for Dermatology
For dermatologists, revenue in the office is generated by procedures and office visits. Often, both are provided on the same day. See the dermatology section of our specialty page for articles about the use of modifiers 25, 51, and 59. Frequency distribution for new and established patients 2023 E/M data released at the end of […]
Coding Guide – Advanced Primary Care Management
CMS developed new HCPCS codes for primary care practitioners who provide care management services and communications-technology based services on a monthly basis. These are an alternative to other care management codes, and acknowledge that much of the work caring for patients occurs outside of regular office visits. These Advanced Primary Care Management (APCM) codes are […]
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 their facility. A visit may be with a physician, non-physician practitioner (NPP), psychologist or social worker. There are some differences in RHC and FQHC rules, but in general, a […]
Coding Guide – Federally Qualified Health Centers
If you are looking for a guide to coding for Rural Health Center (RHC) or Federally Qualified Health Center (FQHC) visits, here it is. Clinicians in RHCs and FQHCs use CPT® and ICD-10-CM codes to select their services, but these are submitted with HCPCS qualifying visit codes. It’s easy for clinicians in these mission driven […]
Performing Services that Increase Primary Care Revenue
Wellness Visits and Problem Visits at the Same Encounter Transitional Care Management Chronic Care Management Advance Care Planning HCPCS codes with low RVUs Advanced Primary Care Management Services | G0556, G0557, G0558 Post-operative Care Services Add-on Code | +G0559
Behavioral Health Coding Compliance
Once again, with feeling: coding for behavioral health Coding for Behavioral Health Compliance lessons from the OIG Post-discharge Telephonic Follow-up Contacts Intervention | G0544 Digital Mental Health Treatment | G0552, G0553, G0554 Safety Planning Interventions | G0560 It’s been a year (seems like a minute) since the OIG released a report on coding for behavioral […]
Screening for Other Sexually Transmitted Illnesses (STI)
This article covers CPT® and diagnosis codes used for screening for other sexually transmitted illnesses. It includes descriptions and screening criteria. To tell whether or not you can collect a co-pay for the testing or not can be found on the U.S. Preventive Services Task Force (USPTF) website [1]. The Affordable Care Act mandated that […]
Anticoagulation Management
There are a few remarkable things about coding for anticoagulation management services. First, payment for these services bolsters Medicare’s support for primary care. This monitoring is typically done by either primary care or cardiology and was considered part of the pre-and post-work for an office visit. Although there were CPT® codes for anticoagulation management prior […]
Billing Medical Practice Services for Patients on Hospice
Overview of Hospice Care Additional Services (non-Hospice Organization) Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their end-of-life care provided by a hospice organization (the “hospice”). Medicare then pays hospice to provide all the care that the patient needs that is related to […]
Behavioral Health and Telemedicine
In this post Overview of behavioral health services via telemedicine during the PHE Overview of behavioral health services after the PHE The Omnibus spending bill passed at the end of Dec. 2022 extended telehealth flexibilities for two years after the end of the PHE. The final MPFS 2025 extends the delay for the -in-person visit […]
Aftercare and Follow-Up: ICD-10-CM Coding
Aftercare visit codes are assigned in situations in which the initial treatment of a disease has been performed but the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. ICD-10 makes two important points about the use of aftercare codes in the final chapter. The aftercare […]
Overview of FQHC and RHC Coding | Webinar
Recorded February 20th, 2025
1 CEU expires 2/28/26
Federally Qualified Health Centers (FQHCs) operate in rural and urban areas, and provide services to Medicare, Medicaid patients and privately insured patients. Rural Health Centers operate in rural areas and also provide services to Medicare, Medicaid and privately insured patients.
Everyday Coding for Medical Practices
Everyday Coding is Betsy’s signature course. We’ve gathered all the components here in one convenient spot. You can work through them one at a time, select just the ones you need, or customize training for your physicians and staff.
RHC and FQHC Update
Background Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) have specific rules related to coding for service in their clinics. Both submit claims on a UB claim form that shows a revenue code and also includes the specific HCPCS/CPT® codes that were performed. RHCs (generally) are paid an all-inclusive rate for services done […]
Assuring Compliance for Behavioral Health Services | Webinar
Recorded August 15th, 2024
1 CEU expires 8/30/26
Guest Presenters Cheryl Krusch and Natalie Laaman of BerryDunn
This webinar reviews essential documentation requirements and coding standards, describes common denial reasons, and provides proactive steps to mitigate risk effectively. Elevate your practice’s compliance standards and ensure proper documentation and coding for revenue integrity.
Billing for Pap Smear
Billing for pap smears in a physician practice can be confusing for clinicians and coders alike. Pap smears can be screening services or diagnostic services There is a HCPCS code for obtaining a screening pap smear, Q0091 Performing a pelvic exam is either part of a preventive medicine service or problem oriented visit A new […]
G0101 Pelvic and Breast Exam
Medicare developed two HCPCS codes for screening services for women, without definitive frequency time limits Both G0101 (screening breast and pelvic exam) and Q0091 (obtaining a screening pap smear) may be billed every two years for a low-risk patient and every year for high-risk patients These are not comprehensive preventive medicine services They may be […]
Commonly Performed Procedures in Primary Care
These reference sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick reference. The first chart includes codes 10060-11443, the second 11600-17111, and the third 20550-54056.
Incident To Services – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an office. This article includes: Description, explanation and codes for incident-to services Billing and coding rules Brief video overview Enrollment of non-physician practitioners (NPPs) for incident-to billing See our Medicare Incident-to and Shared […]
Nursing Facility Visits
Definition Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing facility. Explanation Only a physician may perform an initial nursing facility service in a SNF. This includes admissions and re-admissions. In an NF, a non-physician practitioner (NPP) who is not employed by the NF may […]
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