Nicoletti Notes May 2026 Published on May 12th, 2026 HEALTHCON in Dallas was filled with great presentations and enthusiastic coders, billers, and compliance professionals. One of the sessions I was most grateful to attend was the AMA’s session on maternity care coding, presented by Leslie Prellwitz, MBA, CCS, CCS-P, CPMA. Her title at the AMA […]

Nicoletti Notes April 2026 Published on April 14th, 2026 Let me start with two pieces of advice: Don’t post coding questions that will raise compliance eyebrows on message boards. Don’t respond to postings with capital letters or the word “fraud.” Here are the posts in question. The original post was deleted moments later, after the […]

Nicoletti Notes March 2026 Published on March 10th, 2026 It’s the time of year when residents are looking for jobs, evaluating offers, and deciding where to take their first attending job. It’s exciting. Congratulations to finishing med school and residency. It’s the time of year when residents are weighing geography, the culture of an organization, […]

Nicoletti Notes August 2025 Published on August 28th, 2025 The July 2025 CPT® Assistant had a question about whether CPT® 99459 could be used on a male patient for an examination of external male genitalia and a digital rectal exam. CPT® said no. 99459 is intended to be used with a pelvic exam to cover “the additional supplies […]

Nicoletti Notes October 2025 Published on October 2nd, 2025 We’ve updated CodingIntel’s Telehealth article again. We’ll keep you up-to-date with the latest Medicare rules. Medical coding is a high-stakes discipline as accuracy affects reimbursement, compliance, and the overall health of the revenue cycle. Just as a reminder, here are three frequent mistakes to watch out for—and how […]

Nicoletti Notes November 2025 Published on November 18th, 2025 CMS is changing the definition of HCPCS code G0136. They are keeping the code and the valuation of the code. The code is staying on the telehealth list. But there is a completely new definition. Between now and 12/31/2025, G0136 is for an assessment of a patient […]

Nicoletti Notes September 2025 Published on September 9th, 2025 CMS released an updated MLN guide for Evaluation and Management Services in July and removed it in August. I’ve saved a copy, however, and you can download it from CodingIntel’s site. (link below) What’s new in the guide? This is old news. Since 1-1-2025, a practice could […]

Nicoletti Notes December 2025 Published on December 16th, 2025 Coding and billing compliance are big subjects, and small errors can lead to big consequences. Whether you’re managing a clinic, overseeing billing operations, or leading a coding team, staying vigilant is key. Here are three essential tips to help your organization stay on track and avoid […]

Nicoletti Notes January 2026 Published on January 13th, 2026 Time-based coding for Evaluation and Management (E/M) services can be a powerful tool, but only when used correctly. Incomplete or vague documentation of time can lead to denials, audits, and compliance issues. Here’s a breakdown of the best and worst practices when documenting time for E/M […]

Nicoletti Notes February 2026 Published February 10th, 2026 Transitional Care Management (99495, 99496) Family practice and internal medicine providers continue to ramp up their use of transitional care management (TCM) services. As background, the TCM services comprise two codes – the “at least moderate” level of medical decision-making (MDM) code 99495 and the “high MDM” […]

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 […]

This article describes the proposed HCPCS codes in the PFS with the proposed payment and highlights for each code set. Coding highlights from the 2025 PFS proposed rule Medicare releases proposed policy changes for medical services for the next year each July, accepts comments on the proposals for 60 days, and sends out the final […]

Question: Can you settle this question for our coding team? Are smoking and drinking considered Social Determinants of Health? Answer: No. According to the CDC: “Social determinants of health (SDOH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set […]

Question:  How much detail do I need to include in documentation for Advance Care Planning? Answer: Document the discussion in enough detail that someone reading the note knows what was discussed. Is that a circular argument? Here’s the example that I give. If a surgeon performs an appendectomy, we wouldn’t bill for the service if […]

Knowing which Medicare wellness visit to bill Eligibility requirements for the Welcome to Medicare visit After I gave a presentation at a family medicine conference a physician said to me, “What you just told me will pay for the entire cost of my coming to this conference.” I don’t always hear that after I give […]