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 […]
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.
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 […]
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 […]
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® […]
Office Visit Code Selection for Medication Management
Medication management performed by psychiatrists, psychiatric nurse practitioners and physician assistants is billed with Evaluation and Management codes. This could be any type of E/M service, a nursing facility service or home visit, but is most typically billed as an office/outpatient visit for an established patient, using codes 99212-99215. Members can download the medication management […]
How Medical Practice Services are Paid | Webinar
Recorded May 20, 2021
The coding and reimbursement system is anything but simple. This webinar will explain how services are paid in fee-for-service medicine, and the use of CPT codes, HCPCS codes, ICD-10-CM codes, bundling, and payer policies. It is a broad overview aimed at describing “who makes up these rules” and where to look for definitive, citation-based answers.
Coding for Behavioral Health Services by Psychologists, Social Workers and Therapists
Looking for a coding resource for behavioral health therapists? It’s here. This video was recorded before CMS added Marriage and Family Therapists and Mental Health Counselors to enroll in Medicare. These professions aren’t noted but the are updated on the slide. Therapists use CPT® codes to describe what services they perform and ICD-10 codes to […]
Essential Documentation for Medication Management and Psychotherapy
When providing both medication management and psychotherapy, practitioners need to document the time spent in psychotherapy and describe the therapy. Beginning January of 2021, when billing an office visit, select the level of visit based on medical decision making, not time. If medication management is the only service performed on that date, the clinician can […]
Specimen Collection For COVID-19
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY CMS’s 4/30/2020 rule states that practices could bill 99211 for new or established patients during the public health emergency for COVID-19 specimen collection CPT had previously recommended this The new HCPCS codes (G2023, G2024) for COVID-19 specimen collection […]
Medicare Changes Telehealth Rules, Again
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY. Some codes in this post have since been deleted. This note added 2/11/2025 Medicare changes telehealth rules, again: April 30, 2020 interim final rule with comment period (IFC) https://www.cms.gov/files/document/covid-final-ifc.pdf CMS released a second IFC with policy changes during […]
CMS Update on Medical Record Documentation for E/M Services
The world as we knew it Both the 1995 and 1997 evaluation and management (E/M) documentation guidelines stated that ancillary staff could record a review of systems (ROS), and past medical, family, and social history (PFSH) in a patient record. The billing physician/NP/PA needed to document that that information had been reviewed and verified. Only […]
Psychiatry Exam Reference Sheet 1997 Guidelines
Use the exam example below to meet the requirements of a comprehensive, using the 1997 single specialty psychiatry exam.
Coding Guide – How Physician Services are Paid
This is an essential resource for new physicians, non-physician practitioners, coders and billers and for managers who want to know just enough to manage. In addition to this billing guide, be sure to reference the helpful infographic and Betsy’s 15 minute video on the payment process.
Coding Guide – E/M Services
This coding guide describes the guidelines for evaluation and management (E/M) services reported in the office or outpatient department, consultations, ED visits, inpatient and observation hospital visits, nursing facility and home services. There are specific changes related to these categories of codes described here. The guide will also discuss how to select the level of service based on either time or medical decision-making.
E/M Services – History and Exam
History and exam for E/M services “E/M Codes that have levels of services include a medically appropriate history and/or physical examination when performed. The nature and extent of the history and/or physical examination is determined by the treating physician or other qualified healthcare professional reporting the service. The care team may collect information and the […]
Procedure Coding for Diagnostic and Therapeutic Colonoscopies
“A colonoscopy is the examination of the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum or small intestine to an anastomosis.”[1] CPT® definitions Proctosigmoidoscopy is the examination of the rectum and may include examination of a portion of the sigmoid colon. Sigmoidoscopy is the examination of […]
New Versus Established Patient Visits
There are other articles on CodingIntel about the difference between new and established patients, and the rules haven’t changed, but that doesn’t mean it is always clear. This article is here to try and clarify any remaining questions you have about the differences. Medicare definition “Interpret the phrase “new patient” to mean a patient who […]
Overview of Diagnosis Coding for Behavioral Health Services
Match diagnoses on the claim form to those listed in assessment The diagnosis codes on the claim form should match those in the note. If the assessment says “stable on medications” or “doing well,” it isn’t clear how many conditions were managed and treated In the assessment, list conditions managed, their status, and treated Note […]
Psychiatric Diagnostic Evaluation
There are two codes for psychiatric diagnostic evaluation. 90791 Psychiatric diagnostic evaluation 90792 Psychiatric diagnostic evaluation with medical services 90791 is used by psychologists, social workers and other licensed behavioral health professional and 90792 is used by psychiatrists and psychiatric nurse practitioners and physician assistants, because it includes medical services. Here is how CPT® defines […]
- « Previous Page
- 1
- …
- 8
- 9
- 10
- 11
- 12
- …
- 15
- Next Page »