2021 CPT® E/M Guidelines for Office/Outpatient History and Exam The Guidelines for Office or Other Outpatient E/M Services will help you understand the revised E/M codes and how to apply them in 2021. The History and/or Examination portion of these E/M guidelines explains that office and other outpatient E/M services include “a medically appropriate history and/or […]
Read MoreHealthcare professionals across a wide range of specialties commonly report E/M codes on insurance claims to request reimbursement for services. The lengthy process required for accurate E/M coding and documentation has caused a lot of confusion and frustration for medical coders and providers over the years. That is one reason why the American Medical Association […]
Read More1. Insurance Verification Checklist Ask the right questions during insurance verification. Front office staff should enter information gleaned from the insurance card, phone calls with the insurance company, or electronic eligibility systems. Insurance eligibility verification information in each patient’s electronic medical record for your practice should include: Insurance name, phone number, and claims address Insurance […]
Read MoreThe most consequential changes to evaluation and management (E/M) coding in decades are coming soon, and it’s time to prepare now. When they take effect Jan. 1, 2021, you will no longer need to document the patient’s history of present illness or exam components. Instead, you will be able to document office visit codes 99202-99215 […]
Read MoreDealing with virtual cards In recent years, health plans have shifted from paper checks to electronic methods of physician payment. As part of this movement, many health plans have started paying physicians through payer-issued virtual credit cards (VCCs). When paying via VCCs, health plans send credit card payment information and instructions to physicians, who process […]
Read MoreUpdated April 3, 2020 by the AMA https://www.ama-assn.org/system/files/2020-04/covid-19-coding-advice.pdf
Read MoreJust when you thought you got your head semi-wrapped around Medicare telemedicine rules, they go and throw it out the window! On March 30, CMS issued an Interim Final Rule and released new guidance on how to code and bill for rapidly evolving telehealth services. Before you file another claim, here are the three sweeping changes you must implement […]
Read MoreTo maximize your reimbursement when performing multiple skin procedures in a single patient visit, follow these three steps: 1. Check the total relative value units (RVUs) for each code (https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx) to determine which is valued highest. 2. Check the National Correct Coding Initiative (NCCI) edits (https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index?redirect=/NationalCorrectCodInitEd/) to determine whether the codes are normally considered bundled. […]
Read MoreChanges with NCCI edit rules set forth by the Centers for Medicare and Medicaid Services (CMS) were discovered. Per those changes, as of January 1, 2020, PTs, OTs, and ATCs were no longer receiving payment on the following CPT codes when billed with CPT® code 97530 (therapeutic activities) and/or 97150 (group therapy): 97161: PT evaluation […]
Read MoreHead’s up! New payment rates for Pain Management procedures for 2020 have been released. https://www.asipp.org/Fee%20Schedules/2020PhysicianFinalRates.pdf Also – there will be two new RFA codes in 2020 64624 – GENICULAR NERVE BRANCHES, RADIOFREQUENCY $417.56 in office / $152.66 outpatient 64625 – SACROILIAC JOINT NERVES, RADIOFREQUENCY $510.31 in office / $201.74 outpatient Please note! These are replacing […]
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