In Coding
May 15th, 2017
All billable medical procedures include an “inherent” E/M component, to gauge the patient’s overall health and the medical appropriateness of the service. To report a separate E/M service with modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure ...
In Billing
Apr 24th, 2017
Telehealth is growing in popularity and scope. Most local markets have facilities or patient groups seeing patients via the internet. But there are so many facets to telehealth and reimbursement is relatively recent. How do you make sure the online service provided is reimbursable? Here are 5 tips that will help you be reimbursed: Be ...
Effective January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) proposed that add-on code G0501 could be billed with new and established patient office/outpatient E/M codes (99201-99205 and 99212-99215), as well as transitional care management codes (99495, 99496), when the additional resources described by the code are medically necessary and used in the ...
In CMS
Dec 5th, 2016
Centers for Medicare & Medicaid Services (CMS) evaluation and management (E/M) Documentation Guidelines (DG) allow providers to use an extended history of present illness (HPI), as defined by the 1997 evaluation and management documentation guidelines (DG), with the remaining elements of the 1995 DG. This means that “the status of three or more chronic conditions” ...
In Audit
Nov 23rd, 2016
The Centers for Medicare & Medicaid Services (CMS) has tweaked the tests it says are waived from Clinical Improvement Amendment of 1988 (CLIA), releasing the list effective January 1, 2017. CLIA regulations require a facility to be certified for each test performed. To ensure that Medicare and Medicaid only pay for laboratory tests categorized as waived ...