Recorded  June 19, 2018 The handout for this webinar has been updated with RVUs for 2019. For more about minor procedures, watch Coding for Skin Procedures in Dermatology, Family Practice, and Urgent Care, available on demand. Medical practitioners often find it easier to do a minor procedure than to select the right code for a minor procedure. […]

Psychiatrists, psychiatric NPs and psychiatric PAs provide medication management using E/M codes and psychotherapy services. There are specific rules for performing both on a calendar day. Be sure to review the behavioral health coding guide for more specific information. When a CPT® code is defined by time, the clinician must document time in the medical […]

At the end of 2017, there was news that a new vaccine for shingles, Shingrix, was significantly more effective than the older vaccine, Zostavax.  The new vaccine was recommended in place of the old, and for patients who had already received the older vaccine.  An article in The New York Times summarized the benefits. The […]

Question: Should we always wait for the pathology report before submitting a code for a biopsy? Answer: Sometimes. Wait for the pathology report only for excision of benign or malignant lesions, which are coded based on the pathology report. These codes describe excision of benign lesions in the code series 11400 to 11446 and excision […]

Recorded June 6, 2018 This content is no longer current. Presented by Betsy Nicoletti with guest speaker Edwin Knights, MD Edwin Knights, M.D. was the physician leader in his practice in implementing risk diagnosis coding and brings experience and strategic knowledge to this important topic. Overview: Many practices have a basic understanding of HCC risk […]

Legally, when a physician, physician assistant (PA) or nurse practitioner (NP) enroll in a Medicare, Medicaid or commercial insurance, the practitioner signs an agreement attesting that accurate claims will be submitted. Practitioners are responsible for claims submitted under their National Provider Identifier (NPI). CMS’s E/M guide says, When billing for a patient’s visit, choose codes […]

Do you remember that CMS is talking about changing the documentation requirements for E/M services?  If it slipped your mind in the course of your busy work weeks, you can read my article about that here. CMS E/M listening call March 21, CMS held its E/M listening session and I joined in. First you might […]

Medicare stunned us by creating two prolonged services HCPCS codes for use with Medicare covered preventive medicine services in 2018. They may be used only with Medicare covered preventive services when the typical intraservice time for the preventive service is met, and half of the prolonged care time. CMS then released the intraservice time for […]

Have you heard of Talk Ten Tuesdays? It’s an internet radio program hosted by Chuck Buck and Dr. Erica Remer, and every week they discuss current coding issues. They started with the implementation of ICD-10 and just kept going. I was a guest recently and discussed one of my pet peeves: equating medical necessity with […]

Question: Can two practices split the post-op office care of a patient? Answer: No. Although the operative and post-operative portions of the global package may be split between two groups, there isn’t any way to split the office post-op visits between two practices. CMS developed a single payment for global surgery that includes certain pre-op […]

Recorded February 15, 2018 This content has been removed as it is no longer current. Listen in on this high level overview of new CPT® and HCPCS codes for 2018! Every year, the AMA updates the CPT® code set and CMS updates the HCPCS code set. This year, some 2017 HCPCS codes were changed to […]

CPT developed (and Medicare recognizes) two new codes for services related to home and outpatient international normalized ratio (INR) monitoring services in 2018. Here are the new codes | CPT® 93792, 93793 93792  Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified healthcare professional, […]

Question: Can you please give me your opinion on a coding case? We have a surgical oncologist that performed an excision of malignant skin lesions on the face, using code 11621. A plastic surgeon (in the OR at the same time) performs immediate reconstructive closure. It was an intermediate repair using 12051. It is my […]

Question: Prolonged Services and nursing home visits. I’m getting a “Code 99358 is a column 2 code for 99309, these codes cannot be billed together in any circumstance” error from our scrubber when we try to bill CPT® 99358 and 99309 on the same date of service. I thought these were billable with other E/M’s […]

Recorded October, 2017

Medical practices can decrease denials and accelerate payments by setting up work processes that use advance functions in their software systems to identify, quantify and categorize denials. The purpose is to identify patterns related to coding, enrollment, prior authorization and specific payer performance. This presentation will focus on using these systems related specifically to ICD-10, but the underlying strategy to understand the causes of denials, and reduce or prevent them in the future is applicable for all denial reasons.

99484 Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric […]

Recorded September 21, 2017 When it comes to auditing E/M services, there’s black, white and a whole lot of gray. Reasonable auditors can disagree. So, how can auditors and coders accurately select a level of service? First, by thorough knowledge of the Guidelines themselves. Second, by developing a set of internal, defensible policies that address the […]

Evaluation and Management (E/M) services account for 30% of the revenue paid by Medicare for all physician services. For many specialties, E/M codes account for 60-70% of total revenue. Maximum reimbursement depends on understanding the rules related to these services. The goal of this presentation is to teach these rules for office E/M services with […]

I hope you’re sitting down, because there is big news! The proposed physician fee schedule rule was released in mid July and includes a section about E/M (evaluation and management services). CMS is asking for comments about changing the documentation guidelines! The current guidelines were developed in 1995 and 1997, prior to the adoption of […]

Question: The doctor I work with excised two benign lesions from a patient’s arm, of the same length.  Do I add them together and report one code? Each was .5 cm.  Do I report 11400 twice or 11401 once? Answer: Report 11400 twice. Laceration repairs of the same depth and location are added together, but […]