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 ...
Feb 1st, 2016
Medically unlikely edits add restrictions to these codes. The American Medical Association (AMA) focused on prolonged services for 2016 CPT®. New codes were created and guidelines have been updated. Take note, and apply the changes when reporting these evaluation and management (E/M) services. Report Initial Prolonged Service Once, per Day Although medically unlikely edits (MUEs) ...
Check your nurse’s credentials and payer incident-to rules before billing this E/M service. By Karla M. Hurraw, CPC, CCS-P CPT® 99211 Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are ...
Aug 1st, 2014
Know the best coding approach when a family member or caretaker is present on a patient’s behalf. Typically, insurers (including Medicare) will not cover an evaluation and management (E/M) service with a patient’s family or caretaker(s) if the patient is not present. In such a case, the best approach to ensure reimbursement is to not ...
Learn to correctly unbundle codes for proper payment of these services. By Erica T. Cousin, CPC, CPC-I National Correct Coding Initiative (NCCI) version 20.1 includes code pair 36415 Collection of venous blood by venipuncture and 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the ...