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Diabetes Coding in Hierarchical Condition Coding (HCC)

Diabetes is a common chronic condition, included in three distinct HCC categories Patients often have more than one chronic condition of the disease; page down for a Q&A related to how multiple conditions do–and don’t–affect the risk score CodingIntel members can download our guide to Risk Adjusted Diagnosis Coding for Medical Practices for more explanation and […]

Compliance Issues in ICD-10 Coding for Risk Based Contracts and HCCs

How to be a great HCC coder? Know ICD-10-CM Official Guidelines for Coding and Reporting During an encounter: Code conditions assessed and managed. If treatment of an acute or chronic problem is affected by an ongoing condition, note that, and add the ongoing condition to the claim form. If the condition has a manifestation or […]

Lesion Destruction Tip Sheet

CPT® does not make it easy to locate codes for destruction of lesion(s). These codes are found in multiple chapters throughout the CPT® book, and are classified by a variety of factors (size, method of destruction, type (pre-malignant/malignant/benign), etc.) Accurate coding is essential to accurate payment. This tip sheet was created to help you quickly locate the correct CPT® code for lesion destruction.

Remote Monitoring 99453, 99454 | Reference Sheet

CPT codes 99453 99454 are used to report remote monitoring device set up, supply and recording. This resource answers the questions: who does the work, what is being monitored, how is it done, and what does the practice do.

Coding for Telehealth

In this article: Telehealth and Extended Flexibilites – Feb, 2026 Telehealth Prior to the Pandemic Current Telehealth Rules Important Details (modifiers, frequency, teaching physicians, and more) RHCs and FQHCs Place of Serivce CPT® Codes for Telehealth Is it or isn’t it a Telehealth Service Communication-Based Technology Services Telehealth Flexibilities Extended Until Dec. 31, 2027! Date […]

Coding Guide – Colonoscopy

Colonoscopy coding can be confusing because there are many codes from which to choose. This guide explains the difference between screening and diagnostic colonoscopies. It also discusses when to use HCPCS codes and CPT® codes, and specific colonoscopy modifiers. Reading the procedure report before assigning any codes is very important. Screening procedures can easily turn […]

Consent for Communication Technology-Based Services (CTBS)

Both CPT® and CMS have developed codes for non-face-to-face communication-based technology services (CTBS) in recent years. In addition to care management services, these include interprofessional consults, remote physiologic and therapeutic monitoring, and on-line digital E/M services In the 2020 Physician Fee Schedule Final Rule, CMS clarified the type of patient consent that is required to […]

Commonly Performed Procedures in Primary Care | Reference Sheet

These reference sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick reference. The first chart includes codes 10060-11443, the second 11600-17111, and the third 20550-54056.

Fracture Care Coding Fundamentals | Webinar

Webinar Postponed.
Webinar Date TBD.

Guest presenter Sarah Wiskerchen

This webinar describes the rules for reporting fracture care services using CPT® and Medicare guidelines. It covers the coding distinctions for closed, percutaneous, and open treatment of fractures, clarifies how casting, splinting, and strapping services are treated within the global surgical package, and addresses the correct use of selected modifiers and radiology and supply codes.

Blood Pressure Self-Measurement 99473, 99474 | Reference Sheet

CPT ® codes 99473 and 99474 are used to report specific clinical staff and/or Physician, NP or PA work related to blood pressure self-measurement by patients. This quick reference sheet defines the work, the time required, and lists the criteria for reporting these services.

Critical Care for General Surgery and Trauma Surgeons

Critical care provided as a stand-alone service is based on the seriousness of the patient, the types of intervention, and time spent in direct patient care. Critical care provided by a surgeon to a patient in a global period for procedures with a 10- or 90-day global period, must also follow the rules for critical […]

Clinical Staff Time

Question: : If a nurse helps with ROS, medication reconciliation, etc., would their time (if documented) be able to be included in the time for the visit?  

Coding for Medical Nutrition Therapy Services

Medical Nutrition Therapy Services (MNT) have been a covered benefit under Medicare since the early 2000’s. This article will describe the rules related to coding for medical nutrition therapy services for Medicare patients. This article also addresses common questions about coverage under the Medicare benefit with brief answers and links to the source documents for […]

Outpatient Diabetes Self-Management Training (DSMT) Services

Medicare covers diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an overview of the requirements and provide answers to some commonly asked questions. It will also provide you with links to the source material for DSMT coverage in the CMS Medicare Benefit Policy […]

Coding for Observation Services

CPT® Codes for Observation Services There are two sets of codes used for both inpatient status and observation level of care. Coding for observation services no longer has a distinct set of CPT® codes as those were deleted. The “observation care code” applies to Hospital Inpatient or Observation Care Services Codes: 99221–99223 for initial inpatient […]

Consultation Codes

CMS stopped recognizing consult codes in 2010. Outpatient consultations (99242—99245) and inpatient consultations (99252—99255) are still active CPT® codes, and depending on where you are in the country, are recognized by a payer two, or many payers. In 2023, codes 99241 and 99251 were deleted. These two low level consult codes were rarely used. There […]

Drug Therapy Requiring Intensive Monitoring for Toxicity

Question: When auditing MDM, is there a list of drugs that are considered “drug therapy requiring intensive monitoring for toxicity?” Answer: Not from the AMA or CMS. Some MACs or third parties may have lists. Here’s the definition:  

Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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