You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You provide excellent care for your patients and achieve great outcomes. No […]
The American Medical Association (AMA) says the 2023 CPT code updates emphasize its efforts to reduce administrative tasks. The AMA released the calendar year 2023 CPT code set, which builds on the AMA’s efforts to reduce administrative tasks in medicine, according to a recent press release. The CPT code update contains 393 changes, including 225 […]
Among the changes are a new code for reporting prolonged services in the inpatient or observation setting and significant guideline revisions. The American Medical Association (AMA) recently announced major revisions to Evaluation and Management (E&M) Services, effective Jan. 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, […]
The AMA updated consultation services for 2023. The American Medical Association (AMA) announced major revisions to Evaluation and Management (E&M) Services for Jan 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, emergency department services, consultations, nursing facility services, home and residence services, and prolonged services. Revisions […]
The E&M categories that will undergo revision in 2023 include the following: Inpatient and observation care services Consultations – both outpatient and inpatient Emergency department services Nursing facility services Home and residence services Prolonged services Each week over the next few months will be focused on one E&M category, taking a deeper dive into the […]
Changes to evaluation and management codes are going to take time to get used to. CPT 2023 brings medical coders 101 new codes sprinkled throughout the code set, but it’s the revised and deleted codes you’ll want to pay the closest attention to. Deleted CPT® 2023 Codes To understand the revised evaluation and management (E/M) […]
What you need to know to avoid claim denials and to maximize practice revenue Despite your best efforts to follow billing guidelines, payers still deny your claims. Or in some cases, they pay you and then take the money back. Experts say you can’t ever eliminate denials and post-payment recoupment entirely, but you can reduce […]
Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to […]
Validating the shift to higher office visit levels and the impact of the 2021 E&M guidelines. Between 2019 and the end of 2021, a lot changed. Not only did the COVID-19 pandemic impact the way in which physicians and hospitals saw patients, but the introduction of the new 2021 Evaluation and Management (E&M) guidelines was […]
It is critical to submit comments on proposed rule on critical care. As I said last week, the Physician Fee Schedule Proposed Rule for the 2022 calendar year (CY) came out July 23, and the Centers for Medicare & Medicaid Services (CMS) is soliciting comments by Sept. 13 I’m going to review the proposed changes […]