Ambiguities in the 1995 documentation guidelines create uncertainty. Editor’s Note: After this article was written, a Medicare administrative contractor announced new definitions for “detailed” and “expanded poblem-focused.” See the May issue of Healthcare Business Monthly to learn more. Within the Centers for Medicare & Medicaid Services’ (CMS) 1995 Documentation Guidelines for Evaluation and ...
In my work with clients, I often identify potential coding issues around the frequency of evaluation and management (E/M) visits compared to a benchmark. For example, based on Medicare distribution data, Chart 1 illustrates possible over-coding (relative to 46 percent level 3 and 53 percent level 4 visits) and under-coding (relative to 0 percent level ...
In Billing
Feb 8th, 2017
Time is an alternative option for E/M coding (on many, but not all, of the E/M codes) in lieu of the three key components, history, exam, and medical decision-making. Documentation Guidelines for Time According the Centers for Medicare & Medicaid Services (CMS), “In the case where counseling and/or coordination of care dominates (more than 50%) of ...
The 2017 CPT® codebook features some important changes for coding pelvic ring fractures, including the deletion of two codes, the addition of two new codes, and an added parenthetical instruction. Here’s what you need to know about the updates. Greater Specificity, Differing Treatments, Justify New Codes Codes 27193 and 27914 were deleted for 2017, and ...
Pay attention to five details when filing claims. By Sivaraj Ramesh, CPC, CEMC, CCS To file accurate claims when coding and billing nail procedures, be familiar with the nuances of nail anatomy, common conditions, treatments, services, and procedures. Here are some tips to point you towards better nail reporting. Tip 1: Nail Down Your Anatomy ...