We have received a number of questions from those seeking advice on choosing a coding level when using the new 2021 evaluation and management (E/M) guidelines. The most common questions concern the meaning and interpretation of ideas within the 3 medical decision–making (MDM) categories: the complexity of presenting problem, data, and risk. We are dedicating […]
To select a level of an E/M service, two of the three elements of MDM must be met or exceeded. Q: How do you select an E/M code for an outpatient visit based on documentation of medical decision-making (MDM)? A: Per the 2021 E/M guidelines, effective January 1, providers must select the level of outpatient E/M […]
The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule. CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP). The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule with comment period (IFC-4) and is effective November 2, 2020 through the end of the public health […]
The application of this code will not result in additional payment for a billed E/M visit service. In its February MLN Connects newsletter, CMS reminds providers that HCPCS add-on code G2211 (visit complexity inherent to E/M associated with medical care services that serve as the continuing focal point for all needed healthcare services and/or with medical care […]
Emergency medicine groups face several changes this year, including a new federal ban on surprise medical billing, updates to the Medicare reimbursement formula, changes to the CMS MIPS program, and new billable services. Below is a summary of these changes provided by the experts at Brault Practice Solutions. Federal Ban on Surprise Medical Billing […]
By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual care, standing up new wards in hotels, sports arenas, and schools, and finding new ways to stretch precious supplies. But behind those transformations […]
On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) introduced revisions to the ICD-10-PCS codes, while the most recent batch of CPT® codes was unveiled on January 25, 2021. The American Medical Association (AMA) has been consistently updating CPT codes in response to the release of vaccines, while CMS has been progressively […]
Make sure your practice is well versed on the new codes and guidelines outlined in the 2021 CPT® code set. Advancements spurred by innovation, new technology, and expansion of digital medicine services within the cardiology specialty have increased access to healthcare and, in turn, have resulted in improved health outcomes for patients across the country. The […]
The American Medical Association (AMA) recently added a new CPT code that will be used to report a COVID-19 vaccine candidate under development by Janssen Pharmaceutica, a division of Johnson & Johnson. The new CPT code is: 91303, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, […]
One year ago, it’s doubtful that anyone could have accurately predicted the changes that would occur in healthcare in 2020. While facing the world’s greatest health crisis in living memory, we’ve seen amazing shifts in adapted care delivery and a surge in “telemedicine,” as well as implementation, regulation, coding, and payment adjustments established at great […]