Uncategorized Archives

CMS Teaching Physician Rules Update | Webinar

Recorded February 16, 2023

The teaching physician rules provide payment to an attending physician for services performed jointly by an attending and a resident. The required participation and documentation of the attending varies for E/M services, critical care, psychiatry and procedures. This webinar will review the basics of the CMS rules and the specific participation and documentation requirements for each type of service. The presentation will also include a description of the waivers in place during the PHE.

Shared Visits – Medicare and CPT

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…

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.

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 […]

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 […]

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.

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.

Implementing Prolonged Services Codes

Question: I understand from your article about prolonged services in 2021 that CMS won’t pay for prolonged code 99417 and instead developed a HCPCS code for the service. (G2212) Do you have any recommendations about how to manage this in the office? Answer: Although in general, I believe most clinicians can code for most of […]

E/M Auditing Webinar: Using the Updated AMA Guidelines

Recorded June 16th, 2021

The AMA issued technical corrections related to the 2021 E/M guidelines for new and established office visit codes 99202—99215. The most significant changes were how data is credited and a clarification on minor and major procedures. During this webinar, we’ll audit three notes that include crediting data and procedure risk.

HCC Diagnosis Coding Example: Diabetes, Hypertension, Chronic Kidney Disease

If a picture is worth 1000 words, what’s an example worth? An example can show in a glance what it takes paragraphs to write and explain. The one I’ve included in this article shows risk scores for a few common chronic conditions, coded two ways. One follows ICD-10 rules and results in a six-fold increase […]

Defining Problems Using the E/M Guidelines

The first element of MDM is the number and complexity of problems addressed CodingIntel’s members-only webinars on auditing E/M services include poll questions, and looking at the poll results during our webinars, I think there is some confusion about the definition of problems. Some people selected self-limited problems for cases in which the patient had […]

Insights: Changes in Level of Service Using Office Visit Guidelines

The American Medical Association (AMA) changed the definitions for codes 99202–99215, effective 1/1/2021 Medical practices are struggling to accurately apply these new definitions to office visits There are significant shifts in the level of service calculated from 2020 to 2021 Both the AMA and CMS said that they didn’t anticipate that levels of service would […]

Office Visit Fees in 2021

2022 Conversion Factor – $34.6062 CMS released the updated conversion factor for 2021, and it is $34.89. This represents about a 7.7% increase from the conversion factor released in the final rule, but is still a decrease from 2020. The RVU values for office and outpatient codes 99202—99215 were changed from 2020 to 2021. Many […]

Billing for Joint Injections | Reference Sheet

When doing a joint injection, sometimes a separate E/M service is billed on the same day, and sometimes, it’s not. This grid will help you determine when to bill for both services, and when to bill only for the joint injection.

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