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Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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June 8, 2023

As time goes by

One of the complexities for medical practices is using time in CPT® coding. CPT® has long had a unit of time rule that a unit of time is met when the midpoint has passed. That is, you’ve reached an hour after 31 minutes. There are many CPT® codes that follow this mid-point time rule including critical care, psychotherapy, and physical and occupational therapy services that are time based. Evaluation and management services do not follow the rule. The time in the description of E/M codes must be met in full when using time to select a level for those services. Other services also require that the total time in the CPT® description is met. Download our reference sheet and watch the video to learn which codes do and don’t follow the CPT® time rule.

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Last revised September 14, 2022 - Betsy Nicoletti
Tags: Code sets and reimbursement

CPT®️️ is a registered trademark of the American Medical Association. Copyright American Medical Association. All rights reserved.

Audit tool for Modifier 25

Reasonable coders and practitioners can and do disagree about when a separate E/M service is warranted on the day of a minor procedure. This audit tool for modifier 25 will help determine if a separate E/M service should be reported. Using it consistently will help practices be reliable in their determinations and provide support in payer audits. Sign up for our monthly newsletter to download the reference sheet.

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2023 E/M guidelines for hospital, nursing facility, home and residence services | Webinar

Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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