In Audit
Mar 5th, 2019
Separately billing routine evaluation and management (E/M) services provided on the same day as another medical procedure is typically denied by Medicare. Healthcare providers may sometimes separately bill E/M services if they meet certain criteria and append modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care ...
Know when to code newborn conditions that only require a watchful eye. During an initial newborn evaluation, watchful waiting conditions are findings that usually resolve without medical intervention in a few weeks to a few years. Some watchful waiting issues require continued outpatient evaluation until resolution. Let’s review which conditions should be reported and when. ...
2017 CPT® codes more accurately report and justify reimbursement for providers of physical medicine. New physical therapy (PT), occupational therapy (OT), and athletic training (AT) evaluation codes are the first significant changes to CPT® physical medicine and rehabilitation codes in two decades. Far more numerous, informational, and specialty-focused, the new evaluation codes solve a long-time ...
Sep 26th, 2012
Successful coding often means knowing what a payer wants. The CPT® codebook instructs you to append modifier 24 Unrelated evaluation and management service by the same physician during a postoperative period for an unrelated evaluation and management (E/M) service during the global period of a previous procedure. CPT® and the Centers for Medicare & Medicaid ...
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 ...