Medicare has specific rules for billing for nurse practitioners and physician assistants using shared services. These rules are explained in this article. CodingIntel members can also download the Medicare Incident-to and Shared Services Coding Guide and split/shared quick reference sheet Definition Shared or split services are Evaluation and Management (E/M) services performed jointly between a […]
Audit Tool for Modifier 25 | Reference Sheet
Download Reference Sheet 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 […]
Coding Hospitalist Services | Webinar
Recorded November 17, 2022
Understand changes to the 2023 E/M code set for hospital services, including inpatient, observation, and emergency department encounters. The American Medical Association is extending the 2021 framework for office visits to the remainder of E/M services selected by key components or time. In the process, they have consolidated hospital and observation coding, and changed the guidelines related to reporting these services. The medical decision-making grid has additions that directly…
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 […]
2023 E/M Guidelines for Hospital, Nursing Facility, Home and Residence Services | Webinar
Recorded September 22, 2022
As expected, 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. They extended the documentation framework in place for office visits to these codes. They also deleted twenty-five codes. Coding for prolonged care services gets…
2023 CPT® E/M Changes
Ready to learn about the 2023 CPT® E/M changes? There is a significant update to the Evaluation and Management (E/M) section of the CPT® book. There are 25 codes that are going away. There are revisions to the introductory guidelines related to five different categories of codes. Prolonged services are getting yet another overhaul. This […]
Coding Principles for Practice Administrators | Webinar
Recorded: July 21, 2022
Administrators managing both fee-for-service and value based payment contracts must maximize revenue and minimize risk in coding for services performed in their practices. This webinar will provide a framework for administrators when they are called on to mediate coding disagreements within their practices.
CPT® Coding for Obstetrical and Gynecological Procedures | Webinar
Recorded: June 23, 2022
Guest Presenter Shannon McCall of HCPro
This webinar will review obstetrical global package codes , colposcopic/hysteroscopic procedures, and FY 2023 ICD-10-CM proposed additions for OB/GYN diagnoses. Shannon will also describe when it is appropriate to unbundle pregnancy package codes, how to assign CPT® codes for abortive outcomes and more.
Does a Practitioner Need to Document Time for a Telehealth Visit?
Question: Does a practitioner need to document time for a telehealth visit? What if it is audio only? Answer: First: For a telehealth visit, always document if it is with video or audio only. Documenting “telehealth visit” or “telemedicine visit” doesn’t differentiate this. Second: If you are using office visit codes (99202—99215), you can select […]
E/M Auditing | Webinar
Recorded April 21, 2022
In this webinar, Betsy audits three E/M notes, one primary care note, one medical specialty note, one surgical specialty note. Using the sample notes, this webinar reviews the three elements of medical decision making. Poll questions, allow participants to think about their assessment of the components of each note and compare their assessment with their peers.
Modifier Update
Recorded February 17, 2022
CMS released four new modifiers at the end of 2022, and CPT released one. These include modifiers for split/shared services, critical care in the post op period, audio-only telehealth services and physician supervision via audio/visual communication. It’s a lot of change for medical practices and coders. This webinar will describe the rules for using these services, based on CMS transmittals released mid-January. There will be a brief discussion of the new place of service code 10 and CMS’s policy about it.
When to Use CPT® Modifier -93
CodingIntel has a more complete article about modifiers 93 and 95, so be sure to read that. This is a brief Q&A, and doesn’t contain all you need to know. Modifier 95, 93: Telemedicine Question: In 2022, the question was, “should we begin using the new CPT® modifier -93?” Now, the question is, when should […]
Coding and Reimbursement for Lactation Services
Questions about coverage and payment for breastfeeding and lactation counseling services come up regularly. And, payers change their policies. It is important to keep up-to-date with the commercial payers with which you have contracts. Is lactation counseling separately billable or considered part of the obstetrical package? What if the patient sees the physician and a […]
New Vaccination Codes for 2022
The 2022 CPT® book had some new vaccination codes and some vaccination codes that practices have been using in 2021. These include codes for the serum and administration of COVID-19 vaccines, which came out during the past year and now are incorporated into CPT®, and a few new codes. The 2023 CPT® book includes added […]
How Old is Your Oldest CPT® Book
My, how CPT® has grown Thank you to everyone who completed our mission critical survey: how old is your oldest CPT® book and how many pages is it? Page down: a summary chart is below. First, some of you save everything. I’d love to see your office shelves. There are coders out there who have […]
Update to ICD-10-CM in 2022 including COVID and SDoH | Webinar
Recorded November 18, 2021
While there are only 159 new diagnosis codes in the ICD-10-CM code set, effective October 1, 2021, there updates to the official guidelines that coders need to know about. Not surprisingly, the guideline changes emphasize specificity. There are new codes for the Social Determinants of Health (SDoH) and who can document these in order to capture them on the claim form. There is a new code for post-COVID-19 and instructions for its use. This webinar will highlight…
Best Practices in Revenue Cycle Management | Webinar
Recorded October 21, 2021
Guest presenter Elizabeth Woodcock
In this webinar, speaker, author, and consultant Elizabeth Woodcock provides a roadmap to optimize your practice management system, prevent denials, and strengthen cash collections.
Why Not Bill All 99213 Visits in an FQHC?
Practitioners who work in Rural Health Centers (RHCs) Federally Qualified Health Centers (FQHCs) can get in the habit of billing all level three office visits, understanding that for Medicare and Medicaid patients, payment is the same no matter what level of service is reported. Whether the visit was a simple visit or the patient had […]
Can We Bill a New Patient Visit for Preventive and E/M Services on the Same Day?
See our on-demand webinar, Preventive medicine and Medicare wellness visits with an E/M. Question: Our physician saw a patient and did a preventive medicine service and addressed an acute, significant problem. The patient was new to us. Should we bill both as new patient visits? Answer: The last time I saw this addressed by CPT® […]
Does HCPCS Code G0444 Require a Full 15 minutes?
Question Does HCPCS code G0444 require a full 15 minutes, or can you use it if 8 minutes are documented? Answer The reason for this question is that some codes follow the CPT unit of time rule, from the front of the CPT book. And some codes require the full length of time. How do […]
Coding Office Visit Codes 99202—99215 | Webinar
Recorded June 12th, 2021
It’s here, the first major changes for selecting an E/M service since 1997. Clinicians are only required to document “a medically appropriate history and/or physical exam, when performed.” Code selection is based on time or medical decision making. The instructions on using time for codes 99202—99215 are all new.
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