Tag: Evaluation and Management


Using Modifier – 25 on an E/M Visit

In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason […]
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Expanded Telehealth Services Won’t Lower Healthcare Costs

  Contrary to widespread hopes, the growth in telehealth brought on by the COVID-19 pandemic probably won’t lower health care costs. But it may make some services more widely accessible. A new Kaiser Family Foundation study compares average 2020 commercial insurance payments for evaluation and management and mental health therapy claims for services provided via […]
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2023 CPT Code Set, Aims to Reduce E/M Coding Burden

The 2023 CPT code set will update the rest of the E/M code section after significant changes in 2021, as well as revise AI and virtual care codes. The American Medical Association (AMA) has released the Current Procedural Terminology (CPT) code set for 2023, which contains updates that aim to reduce medical coding burden for […]
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New EM Billing Guidelines for unreimbursed Services | Case Studies | AllZone Management Services Inc.

New E/M Billing Guidelines for Unreimbursed Services

Recent changes to evaluation and management (E/M) billing guidelines that allow physicians to bill for previously unreimbursed services are producing higher revenues for longer patient visits, according to results of a new study. The study in JAMA Network Open looks at the financial impact of CMS’s 2021 expansion of its time-based billing guidelines to include […]
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Update Your CPT 2019 Code

Update Your CPT 2019 Code Book with the Latest Additions And Revisions

GET OUT YOUR 2019 CPT® CODE BOOKS. YOU HAVE SOME CODE CHANGES TO MAKE. Effective July 1, 2019, the American Medical Association (AMA) is adding 21 new lab codes and deleting one in Appendix O, Multianalyte Assays with Algorithmic Analyses and Proprietary Laboratory Analyses. Deleted 0057U Oncology (solid organ neoplasia), mRNA, gene expression profiling by […]
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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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