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 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 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 […]
Read MoreThe 2020 update to the Medicare Physician Fee Schedule includes six new codes that are part of the 2020 Current Procedural Terminology (CPT®) code set will help physicians and others report a range of digital health services including electronic visits through secure patient portal messages. The new codes are spurred by digital health tools that are growing […]
Read MoreIn calendar year (CY) 2020 Final Rule, Medicare made significant updates to the Care Management (CM) Current Procedural Terminology (CPT) codes and related services. This coding corner focuses on the changes from the following CM categories: Transitional Care Management (TCM) Services; Chronic Care Management (CCM) Services; and Principal Care Management (PCM) Services Transitional Care Management […]
Read MoreWhen you think of Thanksgiving, EHR and medical billing codes most likely don’t come to mind, so here’s a list of our top 10 helpful Thanksgiving ICD-10 codes: W71.43 Pecked by turkey (let the pros kill it next time) W61.42 Struck by turkey (was he wearing gloves?) W61.49 Other contact with turkey (next year, cook […]
Read MoreBefore an effective, clinically driven RCM strategy can be implemented, an understanding of current financial health must exist. Practices can leverage a number of best practice metrics to make this determination. [oc_spacer height=”10″] WHY IS DAYS IN AR IMPORTANT? When money is tied up with payers, practices lose momentum with cash flow as well as […]
Read MoreIn simple terms, RCM (Revenue Cycle Management) refers to the steps that healthcare organizations must take to receive payment for services rendered. Historically viewed as a straightforward back-office function, RCM now touches every aspect of a practice. A complete RCM strategy is comprised of three main functions: Generate revenue: Practice survival and sustainability depend on […]
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