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 ...
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 ...
Feb 1st, 2013
When time is a key factor, follow these five basic rules. By G.J. Verhovshek, MA, CPC   For 2013, the American Medical Association (AMA) updated their CPT® codebook to better explain the rules for time-based codes. The revised instructions can be found in the Introduction section of the CPT® Professional Edition (page xii), under the ...
May 1st, 2012
Place of service errors are on the OIG hit list, so be sure your coding is up to par. By G.J. Verhovshek, MA, CPC For the third consecutive year, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) has included place-of-service (POS) errors as an area for review in its ...
May 1st, 2012
With so many different interpretations to coding rules, your practice can’t afford not to create one. By Pam Brooks, CPC If coding were described as a color, it would be gray. Even with CPT®, ICD-9-CM, and HCPCS Level II guidelines, and despite regulatory guidance from the Centers for Medicare & Medicaid Services (CMS), the Office ...