Tag: E/M Guidelines

Medical Coding Strategies to Prevent Payer Denials

As a former emergency department physician from the U.K., this individual was well aware of claim denials and rejections, with payers frequently withholding or reducing payments. However, it was only when his personal insurance company, denied his medical claim for a vitamin D test that he decided to delve deeper into the issue. He found […]
Learn More
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 […]
Learn More
cigna-updates-modifier-25-reimbursement-policy

Cigna Updates Modifier 25 Reimbursement Policy

Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
Learn More
Latest-Guidelines-for-Coding-EM-services-in-2023

Latest Guidelines for Medical Coding E/M services in 2023

A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]
Learn More
Latest-Changes-in-the-CPT-Emergency-Department-Subsection

Latest Changes in the CPT® Emergency Department Subsection

Attendees at AAPC’s AUDITCON, Nov. 3-4, 2022, came loaded with questions about the coding and guideline changes for evaluation and management (E/M) services in CPT® 2023. The conference offered several sessions on the subject, including the ED session, “Changes in 2023: Emergency Department,” presented by AAPC Chief Product Officer. The officer provided a high-level overview […]
Learn More
10-Areas-Impact-Healthcare-Organization-in-2023

10 Areas That Will Impact Healthcare Organization in 2023

In a year when many people have very few resources, it is important for healthcare organizations to strategically identify areas of concern on a unique and broader spectrum. Healthcare business owners and clinicians, from the front desk to the C-suite, should at a minimum conduct a risk assessment of these areas and ultimately have policies […]
Learn More
AMA-Releases-2023-CPT-Errata

AMA Releases More 2023 CPT® Errata

E/M, Gastro, and Lab Coders, take note. The American Medical Association (AMA) announced some last-minute corrections to the CPT® code set effective Jan. 1, 2023. Add these to your code book, along with the previously released corrections, to ensure you start the year off right with accurate codes and guidelines. Evaluation and Management (E/M) In […]
Learn More

2021 E/M Changes: Are You Coding Unique Tests Properly?

Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
Learn More

2021 E/M Guidelines FAQ – September

AAPC’s senior VP of products answers more of your questions about coding for office and other outpatient services. Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in […]
Learn More

Time for Nonphysician provider E/M code change.

How do you feel you are handling the new American Medical Association (AMA) evaluation and management (E/M) guidelines? I know I’ve had to stop many times while auditing and make sure I was using the new criteria for office visits. I’ve even tried to use the new guidelines on hospital visits accidentally. I bet I’m […]
Learn More
x