Behavioral health via telehealth is allowed permanently, thanks to the Consolidated Appropriations Act signed in Dec. 2020 and effective January 2021. The Consolidated Appropriations Act of 2021 permanently removed geographic and originating site restrictions for behavioral health services in Medicare, allowing beneficiaries to receive mental health services from any location, including their homes, without rural-only […]
Archives for January 2025
Diagnosis Coding for Antepartum Care
Question: Patient seen for antepartum care but delivered at 38 weeks at a different hospital/physician group. What diagnosis codes should we use for the visits before the birth episode. Answer: The diagnosis coding for antepartum care would be specific to the patient’s condition at the time care was provided. If at the time of the […]
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-CM 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
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.
Diagnosis Coding for Intentional Self-Harm
Another discussion of codes that use placeholder xxxA (or xxx with another 7th character) One of the most searched terms on CodingIntel is xxxA. Experienced diagnosis coders recognize the placeholder digits “xxx” and the 7th character extender A. When we pulled the list of ICD-10-CM codes that have xxxA in them, some relate to self-harm […]
Anatomy of an Audit™
Recorded February 4th, 2025
1 CEU expire 3/30/27
Guest presenters Pam D’Apuzzo and Debra Rossi of VMG Health, and Pam Warren of MaineHealth
These two sessions take a deep dive into the audit process. Session one focuses on E/M Services, and session two, Surgical Procedures & Diagnostic Tests.
National Coverage Determination: PrEP for HIV Prevention | HCPCS Code G0011
Physicians and qualified health professionals (QHP) can provide (get paid for) up to eight counseling sessions per year for HIV risk assessment, risk reduction and medication adherence, according to a national coverage determination (NCD) issued in 2024. Background On September 30, 2024 CMS issued a NCD 210.15, Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) […]