Definition Emergency department (ED) services are E/M services provided to patients in the Emergency Department. Explanation These services … [Read more...]
Advance Care Planning | CPT® 99497, 99498
Advance Care Planning (ACP) 99497 Advance care planning including the explanation and discussion of advance directives such as standard forms (with … [Read more...]
Exam | Documentation Guidelines for E/M Services
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong....) However, we will still need to use them when auditing … [Read more...]
Using Time to Select a Level of E/M Service
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong....) However we will still need to use them when auditing … [Read more...]
Diabetes Coding in Hierarchical Condition Coding (HCC)
Diabetes is a common chronic condition, included in three distinct HCC categories Patients often have more than one chronic condition of the … [Read more...]
Depression Coding and Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, … [Read more...]
HCC Coding: Round Up of Chronic Conditions
I saw on twitter recently that COPD was the third leading cause of death in the U.S. If it was on twitter, it must be true, right? This article … [Read more...]
Don’t forget Care Plan Oversight
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182) The requirements for each are different, … [Read more...]
Care Plan Oversight | Coding reference sheet
This reference chart for Care plan oversight (CPO) includes CPT® and HCPCS codes, with wRVUs, time and patient status. RVUs are updated for … [Read more...]
Billing Physician Services for Hospice Patients | Reference Sheet
Medical practices find the hospice modifiers confusing, and confusion leads to denials and payment delays. Use the decision trees below to help you … [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...]
Dear Resident, Do you Understand Relative Value Units (RVUs)?
Measuring physician productivity with work RVUs: News flash! Physicians are more interested in medicine than coding. No doctor undertook the … [Read more...]
Risk Coding for Medical Practices and Outpatient Services
Introduction to Risk Coding for Medical Practices and Outpatient Services Where do we find the rules for assigning diagnosis codes in medical … [Read more...]
Coding Guide – Risk Adjusted Diagnosis Coding for Medical Practices
Payment systems and reimbursement are ever-changing in healthcare and the rules of yesterday may or may not work tomorrow. Medical practices continue … [Read more...]
Coding Guide – Care Management Services
CMS has a stated goal of recognizing management services provided outside of an office visit. In particular, valuing and paying for care management … [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...]
Selecting CPT® Rules for Excision of Skin Lesions
Many medical practices perform skin procedures. A patient may see a dermatologist, a family physician or a surgeon when the time comes to find out, … [Read more...]
What’s the Difference Between B20 and Z21? Which is Right for Positive HIV Status?
In this post ICD-10-CM diagnosis coding for positive HIV status Update to HIV coding in 2022 Medical practice reimbursement for individual … [Read more...]
History | Documentation Guidelines for E/M Services
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong....) However, we will still need to use them when auditing … [Read more...]
Documenting Exam | Evaluation and Management Services
Lunch and Learn Exam is the second key component of evaluation and management services. This short video discusses the requirements for documenting … [Read more...]
Documenting History | Evaluation and Management Services
Lunch and Learn What does a clinician need to document in the history? Is it okay to say, "non-contributory"? What if the medical assistant takes … [Read more...]
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