Tag: Accurate Coding

EM Coding Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
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Old Medical Code Set

Why Old Medical Code Sets Are Still Essential: A Comprehensive Guide

Remaining current is indispensable in the healthcare industry, yet relying solely on present codes may not always be the optimal solution. When tasked with conducting an audit, handling an appeal, or conducting research on the appropriate code usage for a previous encounter, having a thorough understanding of the code descriptors and guidelines that were applicable […]
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Improving Coding Processes to Achieve Value-Based Care Success

Primary care physicians (PCPs) face increasing challenges in the current healthcare environment: not having enough resources to care for patients, declining practice revenues, and overwhelming administrative burdens. On top of all that, there is a necessary, but mounting pressure to shift to value-based care. Having run a cardiothoracic surgery practice for 25 years, I have […]
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CPT Codes

Six Tips to Getting Paid for CPT Modifiers

CPT modifiers help payers understand all of the distinct services and procedures physicians perform. As the scope of practice for today’s internists continues to expand, these modifiers are also increasingly required to ensure accurate payment, says Toni Elhoms, CCS, CRC, CPC, director of coding and compliance at RT Welter & Associates Inc., a healthcare consulting […]
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