Tag: CPT Codes

Differentiating Between Professional and Facility Emergency Department Coding

ED professional codes are typically assigned by professional coders with specialized training in emergency medicine coding. The CPT® code set, including ED code descriptors and applicable rules, guide this choice based on the documented history, physical exam, and medical decision-making, as indicated by the chief complaint and the nature of the presenting problem. In addition, […]
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How 2021 E/M Coding Guidelines Could Ease Physicians’ Documentation Burdens

Physicians will potentially have a lighter documentation burden and more time to spend with patients in 2021 thanks to an overhaul of Medicare Coding guidelines for outpatient evaluation and management (E/M) services. “The whole point was to have people not document stuff that was not necessary, not relevant to the clinical management of the patient,” […]
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Wound Repair Coding

Wound Repair Coding in 3 Easy Steps

Scour the documentation for three key details to correctly code for wound repair. Accurately coding dermatological procedures can be tricky. It is imperative that medical coders understand the anatomy of the skin and can extract specific information from the clinical documentation. We’ve spent the last two months reviewing the codes and guidelines for damaged skin […]
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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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2020 Therapy Services Code Updates

Updates to the list of Therapy Services Code that sometimes or always describe therapy services under Medicare Part B go into effect Jan. 1, 2020. Make sure your coding and billing staff are aware of the following updates impacting coding for physical therapy, occupational therapy, and speech-language pathology service claims. Biofeedback Coding Two new biofeedback training CPT® […]
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Change is Coming for E&M: Start Preparing Now for 2021

E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is that there’s a year to […]
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Chiropractic Code Changes For 2020

You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
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E/M coding changes

A “bold proposal” to reduce the documentation burden on physicians was released as part of CMS’s 2019 proposed Medicare Physician Fee Schedule (PFS). This seemed to have begun as an effort to listen to stakeholders and address the problems of out-of-date guidelines, cloning, EHR misuse, and problems that have evolved since the inception of the […]
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CPT code 99201

Understanding Why 99201 Will be Deleted

An overview of the proposed Medicare Physician Fee Schedule: The proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially released on Aug. 14, 2019, encompassing various elements. Among these are proposals such as adjusting the PFS conversion factor to $36.09, introducing new HCPCS codes for bundled episode-of-care treatment for opioid use disorders, revising […]
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More Changes Ahead for Evaluation and Management Services

Changes to payment, coding, and documentation policies for evaluation and management (E/M) services finalized in the 2019 Physician Fee Schedule (PFS) final rule are necessary to align with the American Medical Association’s (AMA) revisions to the 2021 CPT code set for office/outpatient E/M visits, according to the Centers for Medicare & Medicaid Services (CMS). The proposed policy changes for E/M visits are […]
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