Category: Medical Coding

CPT Modifiers for Physicians to Get Paid

CPT Modifiers for Physicians to Get Paid

During a typical office visit, physicians may provide evaluation and management (E/M) services, minor procedures and more. The question is: Can they bill for each one separately? In some cases, the answer is no. In others, though, the answer is yes — but they must know what current procedural terminology (CPT) modifier to append. Modifiers […]
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Get Ready for E/M Coding in 2023

Get Ready for E/M Coding in 2023

The reverberations of the 2021 evaluation and management (E/M) documentation guidelines have barely subsided, yet we are already on the verge of witnessing further changes in this segment of CPT® for 2023 – and this time, the implications stretch beyond mere office visits. If your healthcare institution conscientiously adopted the 2021 E/M guidelines, there’s no […]
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Latest updates on Critical Care Coding

Latest updates on Critical Care Coding

Medicare updates its policy for these services to align with CPT®. The Centers for Medicare & Medicaid Services (CMS) revised its Part B benefit policy for critical care services, effective Jan. 1, 2022. Policy changes finalized in the 2022 Medicare Physician Fee Schedule (MPFS) final rule include a new definition of critical care services, who […]
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How to avoid medical necessity denials

How to avoid medical necessity denials

How to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is normally addressed during an AWV. How to avoid it:“I often tell doctors to […]
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