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E/M Coding Alert

CPT® 2018:
Get The Scoop On These New BHI and Behavioral Healthcare Management Codes
Remember: New CPT® code 99493 will replace HCPCS option G0503. For January 1, 2018, CPT®... Read more
Modifiers:
UHC Now Mandates Appending Modifier SA on NPP E/M Claims
Not all payers follow this particular policy, so double-check with your individual payers.... Read more
Case Study:
Analyze This Scenario to Hone Your ACP Expertise For Cleaner Claims
Hint: Don't forget modifier 33. Test your advance care planning (ACP) coding skills with ... Read more
Reader Question:
Think You Can Never Report Modifiers 24 and 25 Together? Think Again
Question: Can you ever report modifiers 24 and 25 on the same claim? Hawaii Subscriber A... Read more
Reader Question:
Look to Critical Care Codes for this Scenario
Question: The patient reported to the emergency department (ED) in respiratory distress. H... Read more
You Be the Coder:
Lesson Learned: Reporting Preventive Service With Problem-Oriented E/M
Question: The physician saw a 39-year-old established male patient for an annual checkup. ... Read more
CPT® 2018:
Get the Scoop on These New CPT® 2018 E/M Codes
Don't miss: CPT® 2018 to delete anticoagulant codes 99363 and 99364. From behavioral hea... Read more
TCM:
Get Your TCM Coding Right Every Time With These Handy Tips
If the patient dies before the 30-day TCM period elapses, don't report 99495 and 99496. E... Read more
Coding Quiz:
When Should You Append Modifier 24 to the E/M Service? Find Out
Remember: Scheduled office visit doesn't rule out modifier 24. The physician provides an ... Read more
Reader Question:
Correctly Handle an Injection Due to E/M Encounter
Question: The physician saw a 24-year-old new female patient for complaints of high f... Read more
Reader Question:
Keep These G Modifiers in Mind for ABNs
Question: What are the G modifiers we may use on our services that need ABN claims? ... Read more
Reader Question:
Determine Correct Modifier for LT Services
Question: One of our physicians, Dr. Adams, is going on a cruise this summer. Dr. Adams ha... Read more
You Be the Coder:
Get to Know 99283 for E/M ED Claims
Question: The patient reported to the ED in the morning for a fever and nausea and vo... Read more
TCM:
Answer 7 Questions to Clarify How You Report TCM Codes
Medication reconciliation and management must occur no later than date of face-to-face vis... Read more
Modifier 25:
Pennsylvania's Independence BCBS Updates Modifier 25 Policy, Reduces Reimbursement
Remember: Minor procedures have a zero-day or 10-day post-op period. If your practice bil... Read more
Reader Question:
Know When to Append Modifier 25
Question: If the physician performs a colonoscopy (45380) on the same day as an initi... Read more
Reader Question:
Avoid Reporting Prolonged E/M Services in ED
Question: Can we code for prolonged E/M services in the ED? Florida Subscriber Answ... Read more
Reader Question:
Discover Which Elements are Needed for HPI
Question: What elements should we look for when selecting the HPI level? Nebraska Su... Read more
Reader Question:
Decipher Modifier Indicator of 1 in CCI Edits
Question: I was looking up CCI edits for 99221 and 99212, and I saw the edits have a ... Read more
You Be the Coder:
Look to 99406 and 99407 for Smoking and Tobacco-Use Cessation Counseling
Question: If our physician performs smoking and tobacco-use cessation counseling, whi... Read more
Medicare Physician Fee Schedule:
2018 Proposed MPFS Suggests Revising 1995 and 1997 E/M Documentation Guidelines
Take note: CMS opens comment period until Sept. 1. CMS's recently released 2018 proposed ... Read more
News You Can Use:
NGS Reverses Original Exam Policy Change Decision
Planned change to EPF and detailed exams no longer considered mandatory. The MAC National... Read more
ACP:
Refine Your ACP Coding Skills With These FAQs
Hint: There are no POS limitations for ACP services. Scratching your head over advance ca... Read more
Reader Question:
Investigate Whether to Bill for 2 ED E/M Encounters
Question: A patient visits the ED in the morning for a fever, nausea, and vomiting, a... Read more
Reader Question:
Avoid Reporting Both 99385 and 99402
Question: The physician saw a 21-year-old female patient for a general adult exam and... Read more
Reader Question:
Follow This Advice for ABNs
Question: A 32-year-old established patient visited our practice for an ob-gyn physic... Read more
You Be the Coder:
Choose the Right Code for This Office Visit
Question: The physician in an independent pediatric office has a patient with irregul... Read more
ACP:
3 Answers Clear Up Your Advance Care Planning Coding Confusion
Experts share what to include in 99497 and +99498 documentation. Navigating the time and ... Read more
Modifiers:
Go Beyond Just Documentation to Master Modifier 57
Hint: Always communicate with your payers. Not sure whether you are appropriately appendi... Read more
Compliance:
Receive a 99215 Denial? Expert Advice Will Show You What You Did Wrong
Hint: Always check the medical decision-making. Unfortunately, you may be one of the rank... Read more
Reader Question:
ED Codes Don't Apply in the Office
Question: Our physician saw a patient in his office for an emergency. Can I use the e... Read more
Reader Question:
Count Removed Organ Towards ROS
Question: If the physician examines a patient who has had an organ removed, cany... Read more
Reader Question:
Find Out When to Append Modifier 24
Question: A patient developed a post-op infection during the global period and return... Read more
You Be the Coder:
See What ICD-10 Codes to Report With 99497 and +99498
Question: What ICD-10 codes can I report with 99497 and +99498? I’ve heard that... Read more
NGS News:
55 Percent of 99215 Claims Incorrect, NGS Review Reveals
Hint: Make sure you submit complete documentation for your claims. Don’t miss what ... Read more
ACP:
3 Tips Help Hone Your Advance Care Planning Skills
Hint: Always document specifics in advance directives. At the beginning of last year, Med... Read more
Modifiers:
Bust These Modifier 57 Myths to Boost Your Bottom Line
Pay attention to the global period. As a coder, you know how important modifiers are on y... Read more
Reader Question:
Use Time as Dominant Factor
Question: My physician saw a patient for arthritis. Although the patient has been to ... Read more
Reader Question:
Medical Necessity Key to Reporting 99212
Question: A patient came in for a flu shot. Can I report an office visit code (such a... Read more
You Be the Coder:
Puzzle Out Split/Shared Vs. Incident-To Visits
Question: Can you please explain the difference between a split/shared evaluation and... Read more
CCI:
Master the Nuts and Bolts of CCI Edits to Excel in Your E/M Coding
Prep for CCI with tips from our pros. CMS created the Correct Coding Initiative (CCI) edi... Read more
Coding Quiz:
How do You Choose the Right Hospital Discharge Code? Find Out
Hint: Time is the deciding factor. It’s no secret that evaluation and management (E... Read more
Coding Quiz Answers:
Align Your Answers With These E/M Coding Solutions
Hint: Study the telemedicine modifiers. Did you make an A+ on our coding quiz? Test your ... Read more
Reader Question:
Get New Health Risk Assessment Instrument Codes
Question: Can you tell me about code 99420? One of our physicians wants more informat... Read more
Reader Question:
Correctly Report Tick Removal
Question: An established patient who has been experiencing pain and itching and notic... Read more
Reader Question:
Learn When to Bill E/M with 29530
Question: After evaluating an established patient’s sprain of the medial collat... Read more
Reader Question:
Decipher Complicated Coding Scenario
Question: A patient came into our office for a scheduled visit, and we sent him direc... Read more
Reader Question:
Don't Use 99211 as Catchall Code
Question: How should I bill the administration of the second and third shot of Gardas... Read more
You Be the Coder:
Understand Exam Levels for Other MACs
Question: Our office is located in New Jersey, and we see patients from Pennsylvania,... Read more
Policy Change:
Understand NGS Policy Update on Exam Levels
As of July 1, detailed exams will require 6-7 body areas or organ systems. Recently, the ... Read more
99211:
Adhere to These Additional Rules for 99211 Success
Don’t mix up 99211 with 99212. Last month, we saw how you can ace your 99211 coding... Read more
Smoking Cessation:
Brush Up on ABCs of Smoking and Tobacco-Use Cessation Counseling
See what info our pro says physicians should include in 99406 and 99407 documentation. Sm... Read more
Reader Question:
Master Telephone E/M Codes
Question: Can you explain when I could correctly report 99441-99443? Florida Subscri... Read more
Reader Question:
Know When to Use Team Conference Code
Question: Could you give me some insight into 99366? Arizona Subscriber Answer:&nbs... Read more
You Be the Coder:
Receive Guidance on 99221 and 99238
Question: Can you bill 99221 and 99238 on the same day under any circumstances? For e... Read more
99211:
Follow These 3 Rules to Ace 99211
Here’s why you never report 99211 for a new patient. Whether you’ve been an e... Read more
PFSH 101:
Hone Your PFSH Skills to Excel in History Coding
There are two kinds of PFSH — pertinent and complete. If you find it challenging to... Read more
Ask The Pros:
Learn 6 Tips to Achieve PFSH Success
You should be familiar with your EHR/EMR system. You’ve seen how important it is to... Read more
Reader Question:
Learn How to Bill E/M 99212, +90833, and +90863
Question: Can you bill separately for these three services if the physician performs ... Read more
Reader Question:
Master 99288 for Emergency Services
Question: Can you tell me more about the requirements for using 99288? Florida Subsc... Read more
You Be the Coder:
Reporting Anticoagulant Management Codes
Question: Can you explain the anticoagulant management codes to me? Are they billable... Read more
Telemedicine:
Always Ace Coding for Your E/M Telemedicine Services
Don’t forget POS code 02 on your telemedicine claims. With CPT® 2017, you&rsquo... Read more
Modifiers:
Master 4 Rules for Proper Modifier 27 Use
Use modifier 27 in hospital outpatient settings only. Turn to Appendix A in the AMA 2017 ... Read more
Reader Question:
Master Neonatal Critical Care
Question: We have a low-level nursery and we get called to the hospital for standby b... Read more
Reader Question:
Understand Inpatient Initial Care Codes
Question: Can you use inpatient initial care codes 99221-99223 more than once in the ... Read more
Reader Question:
Discern Requirements for Preventive Care/Problem-Focused E/Ms
Question: Our providers perform many preventive care services like physicals and well... Read more
Reader Question:
Learn How Often to Update ROS
Question: How often must you update the review of systems [ROS] for a patient? With e... Read more
Reader Question:
Choose 1995 VS. 1997 Guidelines Per Encounter
Question: I’ve heard that I can choose either the 1995 or the 1997 documentatio... Read more
You Be the Coder:
Demystify Custodial Care Center Options
Question: The physician provided services to a new patient in a custodial care center... Read more
ED Coding:
Master Do's and Don'ts of ED Coding
Don't assume only ED physicians can use 99281-99285. If you've ever wanted to learn what ... Read more
Add-On Codes:
Jumpstart Your Prolonged Services Coding Skills
Make sure your prolonged services pass the half-hour mark. Have you ever wondered about y... Read more
Inside the E/M Code:
Tackle MDM & Medical Necessity With This Tutorial
Medical necessity is the over-reaching criteria for all services. Does trying to grasp th... Read more
Reader Question:
Determine Correct Choice for Death Pronouncement
Question: We had a trauma patient come to our hospital. One of our providers saw the ... Read more
Reader Question:
Brush Up On 92002 And 99204 Coding
Question: I work in an ophthalmologist’s office, and there is confusion about w... Read more
You Be the Coder:
Coding for the First Hour of Critical Care
Question: If the doctor meets the requirements for critical care billing and has spen... Read more
Bust Locum Tenens Myths To Stay On Track
Hint: Never leave out modifier Q6 when you report a locum’s services. Imagine this ... Read more
Use Our Handy Guide To Become A Pro At Consults And Referrals
Remember: In a consultation, the consulting physician’s opinion is crucial. Pullin... Read more
Coding Quiz:
Hone Your E/M Coding Skills With 4 Quick Questions
Would you get an A+ on these evaluation and management (E/M) questions? Don't miss out on... Read more
Reader Question:
Get New Vs. Established Patient Right Every Time
Question: I work in a family practice office, and we will be having a new physician j... Read more
Reader Question:
Master Modifier 25 By Identifying Separate E/M
Question: My cardiologist saw an inpatient for acute claudication/ischemia of the foo... Read more
Reader Question:
Watch Out For Hemiplegic Migraines
Question: My physician recently diagnosed a patient with hemiplegic migraines, but I&... Read more
Reader Question:
Navigate Coding For Workplace Annual Well Visits
Question: My physician performs annual well visits for the employees of a company at ... Read more
You Be the Coder:
Decode Social History For Newborns
Question: What would be considered an acceptable social history for a newborn? We are havi... Read more