Be sure to provide adequate clinical documentation to support 99024. By Barbara Aubry, RN, CPC, CPMA, CHCQM, FABQAURP As of July 1, the Centers for Medicare & Medicaid Services (CMS) began auditing claims for nearly 300 targeted services to determine whether CPT® 99024 Postoperative follow-up visit, normally included in the surgical package, to indicate that ...
In CMS
Jul 14th, 2017
Among the many provisions detailed within the 2018 Physician Fee Schedule Proposed Rule, released July 13, the Centers for Medicare & Medicaid Services (CMS) acknowledges that the current evaluation and management documentation guidelines create an administrative burden and increased audit risk for providers: Stakeholders have long maintained that both the 1995 and 1997 guidelines are ...
In Billing
May 1st, 2017
Without a thorough understanding of the guidelines, calculating time may land you in hot water. When time is the controlling factor in a patient’s visit, be sure to capture the appropriate time-based service code. Per CPT®, unless there are code or code-range-specific guidelines, parenthetical instructions, or code descriptors to the contrary, the following standards apply ...
NGS is making certain exam requirements clearer. Under the current 1995 Documentation Guidelines for Evaluation and Management (E/M) Services, 2-7 body parts and/or organ systems are examined for both the expanded problem-focused visit and detailed physical exam visit. This contradictory guidance for determining level of service has frustrated many a provider and coder from day ...
These familiar terms have new meaning in ICD-10-CM. Fracture coding can be a challenge for both physicians and coders, but its effect on hierarchical condition code (HCC) funding in Medicare Advantage, as well as health plan Star ratings, leaves little room for speculation. Knowing how ICD-10 delineates initial and subsequent visits is key. Initial Means ...