In 2023, CPT® revised the codes and concepts used for coding  hernia repair. These represent significant changes for surgical procedures that are some of the most frequently performed surgical procedures. At the start of the repair codes, the American Medical Association (AMA) created new language that says “The hernia repair codes in this section are categorized […]
Archives for January 2023
Coding Guide – Critical Care Services
The CPT® coding rules and the CMS reimbursement rules can be confusing. This guide explains the CPT® coding rules and the CMS reimbursement rules in one place.
CMS Teaching Physician Rules Update | Webinar
Recorded February 16, 2023
The teaching physician rules provide payment to an attending physician for services performed jointly by an attending and a resident. The required participation and documentation of the attending varies for E/M services, critical care, psychiatry and procedures. This webinar will review the basics of the CMS rules and the specific participation and documentation requirements for each type of service. The presentation will also include a description of the waivers in place during the PHE.
Principal Care Management (PCM) Services – CPT® codes 99424—99427
There are two sets of  CPT® codes for Principal Care Management 99424 and 99425 are for time spent by a physician or other qualified health care professional (someone with E/M in their scope of practice) and 99426 and 99427 for clinical staff time directed by a physician or other qualified health care professional These are […]
Chronic Care Management
Medicare and private payers cover chronic care management services if a patient has two or more serious conditions that are expected to last at least a year. See also Principal Care Management And, download our Care Management Coding Guide and CCM Quick Reference Sheet Use of CPT® codes 99490, 99439, 99487, 99489, 99491 and HCPCS […]
Transitional Care Management
This article provides answers to frequently asked questions related to transitional care management services. It includes details about billing for TCM services including: When are CPT® 99495 & 99496 used? What are the requirements for TCM? Can We Code TCM and 99214 Together? Transitional care management for discharge Everyday Coding Q&A – Who needs to […]
Category of Code
Learn more about selecting Category of Code in Everyday Coding, updated annually. This article provides definitions and tips for determining whether an office encounter involves a new patient, an established patient, or a consult, and the guidelines for reporting inpatient, observation, and emergency services. The quick reference chart and key points will help you to quickly […]