Consider this otolaryngology case study to decide when to append modifier 25. The Cigna Group recently postponed a requirement for documentation to be submitted with all claims that include a 25 modified office or other outpatient evaluation and manag...

What to do when the pathology doesn’t correlate to the service provided. The rules for cutaneous (skin) excision coding are straightforward: When the pathology for a lesion is benign, code for excision of benign lesion, 11400-11446; and when the patho...

CPT® guidelines offer clues for what payers and auditors are looking for in op notes. When reading notes or auditing documentation associated with the performance of diagnostic endoscopies performed by otolaryngologists (e.g., 31231, 31575, 31525, ...

Healthcare providers are granted even more latitude for use of telehealth services during the COVID-19 public health emergency. On a Friday, at month-end, the Centers for Medicare & Medicaid Services (CMS) kindly dropped another bomb on us: more t...

Capture full payment for remote visits during the PHE for COVID-19. An interim final rule published in the April 6, 2020, Federal Register explains how to bill telehealth services during the COVID-19 public health emergency (PHE). The final rule goes ...