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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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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4 Steps for Improved Excision Coding

4 Steps for Improved Excision Coding

Consideration of several factors, such as the type of removal, lesion size and location, pathologic results, intent, etc., is key to accurately coding dermatological lesion removal procedures. Let’s review the codes and guidelines for lesion removal by excision and how to avoid common mistakes when coding these skin procedures. Excision – Benign/Malignant Lesions (11400-11646) Excision […]
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Tips for Handling Combination Visits

Tips for Handling Combination Visits

Q: Some of our Medicare patient’s complain about their $20 or so co-pay when we bill ‘Combination visits’, a G0439 Annual Wellness visit  codes(AWV) and another Current Procedural Terminology (CPT) code for managing their problems during the same visit. Is there a good solution to this issue or any advice to maybe remedy this? A: This […]
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Online Checklist for E M Coding Services Transition

AMA Releases Online Checklist for E/M Coding Services Transition

The American Medical Association issued a checklist for the transition to fundamental changes in evaluation and management (E/M) services, a medical coding process in support of medical billing which practicing healthcare providers must use to be reimbursed by Medicare, Medicaid programs or private insurance. The checklist provides a guide for physician practices, which already are […]
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Deciphering the CPT Code Changes

Deciphering the CPT Code Changes

The American Medical Association (AMA) publishes the Current Procedural Terminology code set changes every year, usually in September, for the upcoming new year. The changes impacting CPT 2020 were released on September 4, 2019. There was a total of 394 CPT code changes, of which, 58 affect the surgery center market. 2020 CPT Code Changes […]
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HCPCS Level II Coding Cycles and Procedures

CMS Implements Significant Updates to HCPCS Level II Coding Cycles and Procedures

The Centers for Medicare & Medicaid Services (CMS) announced that, beginning in January 2020, CMS will implement shorter and more frequent HCPCS Level II coding  cycles for requests to modify the Healthcare Common Procedure Coding System (HCPCS) Level II code set. Under the updated procedures, stakeholders will be able to submit code applications on a quarterly basis […]
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