Category: Medical Coding

New Patient EM Denials

New Patient E/M Denials: Mystery Solved

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
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CPT Codes Recognize EM Work That Happens Online

CPT® 2020 Digital Health Code Updates: Expanding E-Visit Reimbursement

Much attention has been given to the landmark overhaul of Evaluation and Management (E/M) office visit codes that took effect in 2021, aimed at streamlining documentation requirements for physicians. However, significant groundwork was already laid on January 1, 2020, with updates to the Current Procedural Terminology (CPT®) code set — changes that recognized the rapid […]
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ICD Coding and Climate-Related Psychiatry

ICD Coding and Climate-Related Psychiatry

Anyone who has viewed the wildfires in Australia knows why it has been called the “canary in the coal mine” of climate change. No wonder that Solastalgia was discovered there. As the ever-increasing carbon is being emitted from the world’s coal mines and other fossil fuel sources, life as we know it is at increased […]
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10 Tips To Prepare Practices For E/M Office Visit Codes Changes

The Centers for Medicare and Medicaid Services has taken steps to overhaul codes used for Evaluation and Management (EM) office visit codes. The initiative aims to reduce documentation burdens that interfere with patient care, the American Medical Association says. The professional organization for the nation’s physicians is providing a series of educational materials to support […]
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Non-Physician Provider Use of E&M Codes

Non-Physician Provider Use of E&M Codes

Q: There seems to be a trend of practices using a variety of staff as ‘educators’ to provide patient education. The more recent ‘twist’ is the billing of E&M codes for non-physician providers, based in either clinical documentation or time-based, under the ‘incident to” provision – even though the physician does not see the patient for these […]
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Medical Coding With AI

The Future Of Work Now – Medical Coding With AI

The coding of medical diagnosis and treatment has always been a challenging issue. Translating a patient’s complex symptoms, and a clinician’s efforts to address them, into a clear and unambiguous classification code was difficult even in simpler times. Now, however, hospitals and health insurance companies want very detailed information on what was wrong with a […]
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