The ICD-10-CM Official Guidelines for Coding and Reporting sets the precedent of rules that all diagnostic coders must abide by. Section I.C. covers the chapter-specific guidelines. These offer detailed information about various conditions that require more thorough reporting guidance than the general guidelines provide. Reading the guidelines in their entirety is incredibly important, but this […]
Smoking Cessation, Substance Use Counseling, Screening, and Intervention Coding, 99406-99609
Although the use of tobacco products is on the decline in the United States, the consumption of alcohol and other addictive substances remains a common preventable problem. As a result, the American Medical Association’s (AMA’s) CPT Editorial Panel included a spotlight on reporting tobacco, alcohol, and substance use cessation, counseling, screening, and intervention codes in […]
DRG Red Flags: A Payor Perspective | Webinar
Recorded November 21st, 2024
Guest Presenter Dr. Amarin “Ty” Alexander
Inpatient DRG coding is based on diagnosis coding. Learn how payers use coding summaries. This webinar describes Present on Admission (POA) conditions that invite scrutiny and why short Length of Stay (LOS) with one Major Complication and Comorbidity (MCC) might raise red flags.
ICD-10-CM Chapter Specific Guidelines – Chapters 7–10
Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]
ICD-10-CM Chapter Specific Guidelines – Chapters 4–6
Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]
ICD-10-CM Chapter Specific Guidelines – Chapters 1–3
Section I.C of the ICD-10-CM Official Guidelines for Coding and Reporting, titled “Chapter Specific Guidelines,” contains 22 chapters. These chapters offer detailed guidance on specific codes and code ranges in the ICD-10-CM manual. This article is part of a series that will delve into each of the chapters in Section I.C to delineate coding protocols […]
FAQ: Scoring Elements in the E/M Guidelines
Scoring MDM elements can be challenging for E/M services This post includes questions related to: Major/Minor Procedure Data Elements (with link to additional resources) General Questions about the guidelines Using Time (with link to additional resources) Social Determinants of Health Major or Minor Procedure? Question: I have a question about how to determine if a […]
Blood Pressure Self-Measurement: Education, Training and Analysis | CPT® Codes 99473, 99474
There are two CPT® codes specifically for blood pressure self-measurement and management. The first is for patient education and calibration of a home blood pressure device The second is for reviewing data collected by the patient at home, with a report and communication back to the patient Here are the official definitions: 99473 Self-measured blood […]
ICD-10-CM Conventions, Structure, and Format: Section I.B
The first step to finding the most accurate code is to confirm that you are working with the correct version of the ICD-10-CM Official Guidelines for Coding and Reporting. The correct version may be the most recent update, or – in the context of retrospective coding– it may need to be a previous version that […]
Transforming Patient Collections: Expert Insights and Strategies | Webinar
Recorded October 16th, 2024
Guest Presenter Elizabeth Woodcock
Gain valuable insights on how to effectively respond to industry changes and actionable steps to enhance your revenue cycle management in this engaging webinar centered around navigating the current inflection point in patient collections.
Compliance Guide
You may have heard about the “Seven Elements for an Effective Compliance Plan.” In fact, if you enter that term in a popular web browser “about 575,000” results appear within seconds. Fortunately, compliance and enforcement agencies endorse the elements and provide great examples on what to do – without having to delve much into those […]
Where Does it Say That? | Webinar
Recorded October 9th, 2024
1 CEU expires 10/30/26
Guest Presenter Pam Warren of MaineHealth
This webinar is a guide for auditors and coders looking for regulatory guidance when they are answering coding, compliance and regulatory questions from practitioners and colleagues. This presentation offers common healthcare compliance scenarios and provides the location of the associated guidance.
HCPCS code G2211
Table of Contents G2211 FAQ Changes to G2211 in 2025 and 2026 Not all visits Clinician’s relationship with the patient, type of problem Acute condition, seen in primary care CMS expected frequency Q&A from CodingIntel’s August 17, 2023, CMS Proposed Rule Webinar G2211 Visit complexity inherent to evaluation and management associated with medical care services […]
“xxxA” – ICD-10-CM Placeholder Code X and 7th Character Extension
When I was reviewing terms people use to find CodingIntel I was surprised to find that people were searching for “xxxA.” At first, I was afraid searchers were looking for a different kind of site….or sight. I hope some searchers were looking for information about placeholder code X and 7th character extension A. These are […]
Developing an Audit Work Plan to Satisfy Your Compliance Program | Webinar
Recorded September 25th, 2024
Guest Presenter Pam Warren of MaineHealth
The OIG identifies seven elements of an effective Compliance Plan. One of them is conducting internal monitoring and auditing. This presentation will look at what to audit, how to evaluate risk, how to set up your audit process, and how to report your results.
ICD-10-CM Conventions, Structure, and Format: Section I.A
As you read this article, it will be helpful if you have the ICD-10-CM book in front of you. You can download a pdf copy here. And even if you don’t download the entire book, download the Official Guidelines instead. There are four cooperating parties to ICD-10-CM. They publish and update the official guidelines for […]
The First Element of MDM: Number and Complexity of Problems Addressed
E/M elements for MDM There are three elements in medical decision-making and this article describes the first of three When selecting a level of service based on medical decision-making two of the three elements are required CPT® has developed definitions for many of the components in the MDM chart. The examples listed in the definitions […]
The Third Element of MDM: Risk of Complications
The third element of MDM: risk of complications and/or morbidity or mortality of patient management at the encounter Coding for E/M Services There are three elements in medical decision-making and this article describes the third, the risk of complications and/or morbidity or mortality related to patient management When selecting a level of service based on […]
Assuring Compliance for Behavioral Health Services | Webinar
Recorded August 15th, 2024
1 CEU expires 8/30/26
Guest Presenters Cheryl Krusch and Natalie Laaman of BerryDunn
This webinar reviews essential documentation requirements and coding standards, describes common denial reasons, and provides proactive steps to mitigate risk effectively. Elevate your practice’s compliance standards and ensure proper documentation and coding for revenue integrity.
IRE Inpatient Determinations: Case Studies | Webinar
Recorded August 13th, 2024
Guest Presenter Dr. Amarin “Ty” Alexander
Independent Review Entities review inpatient records for diagnostic accuracy and DRG determinations. This case-study focused webinar will describe important ICD-10-CM Guidelines that establish the rules for these decisions.
Codes for Visits in Assisted Living (and a Visit Complexity Update for 2026!)
Question: In 2026, how will we indicate practitioners are providing longitudinal or complex care who are in assisted living or receiving services in their home? Answer: In 2023, the codes for services performed in a patient’s home or in an assisted living facility were combined to one code set. Codes (99341—99345 for new patients) and (99347—99350 […]
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