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 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 ...
Oct 7th, 2016
The U.S. Preventive Services Task Force (USPSTF) released in September a final recommendation statement on screening for latent tuberculosis infection (LTBI) in adults. The USPSTF last issued a recommendation on screening for tuberculosis in 1996. Since then, there have been changes in the epidemiology of the disease, development of newer screening technologies, and newer methods ...
Oct 1st, 2016
The guidelines payers impose can affect the codes they allow you to bill for services. Question: I appreciated your spot-on answer in the August issue of Healthcare Business Monthly to the question “What Can I Do if Payers Don’t Follow CPT® Guidelines?” My question is: Are payers allowed to change the definition of a CPT® ...
In Billing
Aug 15th, 2016
The 2017 ICD-10-CM Official Guidelines for Coding and Reporting is now available for download on the Centers for Medicare & Medicaid Services (CMS) website. This latest version includes several changes worth noting. The guidelines are usually released long after publishers’ books have been sent to the printer. This year’s guidelines help explain the significant changes ...