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 ...
In CMS
Oct 14th, 2016
Medicare will pay for the newest CPT influenza virus vaccine, 90674, the Centers for Medicare & Medicaid Services (CMS) announced in a recent transmittal. But because 2017 codes won’t go into effect until after the first of the year, payments won’t begin until January 3, 2017. However, claims with dates of services on or after August 1, 2016 will ...
In Coding
Oct 10th, 2016
Don’t forget the role of medical necessity when reporting a low-level evaluation and management (E/M) service, such as 99211 Office or other outpatient visit for the evaluation and management of an established patient…usually, the presenting problem(s) are minimal. For example, a patient has an established diagnosis of hypertension. The provider documents that the patient should ...