In CMS
Jul 20th, 2018
If you’ve read about the Centers for Medicare & Medicaid Services’ (CMS) proposed changes for the  documentation, coding, and reimbursement of outpatient evaluation and management (E/M) service codes 99201-99215, you probably have some questions (If you haven’t read about the changes, do it!). Now, CMS is providing some answers. Following remarks by CMS Administrator Seema Verma, ...
Mar 1st, 2014
Facility Recognize the impact of “one clinic code fits all” on hospital reimbursement and your coding process. By Jim Strafford, CEDC, MCS-P Effective Jan. 1, 2014, hospitals are required to report outpatient clinic visits furnished to Medicare patients using a single, new HCPCS Level II code, G0463 Hospital outpatient clinic visit for assessment and management ...
In Coding
Feb 3rd, 2014
Level 5, new patient evaluation and management (E/M) code 99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, ...
In Billing
Dec 6th, 2013
This past summer, the Center for Medicare & Medicaid Services (CMS) issued notice that it was considering a radical change for emergency department (ED) and hospital clinic evaluation and management (E/M) coding. With the release of the 2014 hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC PS) final rule, that ...
Jan 1st, 2013
By Denise Williams, RN, CPC-H CMS estimates an “overall” rate increase, but changes cost methodology. In the 2013 Outpatient Prospective Payment System (OPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) bases payments on claims data submitted by hospital providers during 2011. CMS is changing the calculation based on median cost to geometric ...