In Coding
Jan 19th, 2015
Be careful not to apply initial preventive medicine codes (99381-99387) for established patients. A patient who has received any professional service from the provider within the past three years should be treated as an established patient, even if that patient has not previously received a preventive service from the provider. CPT Assistant (August 1997) clarifies: ...
In Billing
Jun 9th, 2014
Evaluation and management (E/M) services comprise a significant portion of most providers’ billable services. To ensure coding (and reimbursement) reaches optimal levels, providers must be careful to document services carefully. Here are five common problem areas to watch for. 1. Legibility When it comes to coding, two fundamental rules are “Not documented, not done,” and ...
In Billing
May 1st, 2014
Understand new and established patient requirements and how to apply them. By G.J. Verhovshek, MA, CPC Most professional coders—even relative beginners—are familiar with the “three-year rule” to determine whether a patient is new or established with a provider. But that familiar rule has a few wrinkles that make determining patient status more complex than you might ...
Dec 2nd, 2013
Working within a group practice can alleviate many of the financial headaches encountered in a private practice, but it also can create new challenges—such as keeping track of new versus established patients. A “new patient” is one who hasn’t received any professional services, such as an evaluation and management (E/M) or other face-to-face service, from ...
Apr 1st, 2013
By Melody S. Irvine, CPC, CPMA, CEMC, CFPC, CPC-I, CCS-P, CMRS As a physician auditor, I spend much of my time educating clinicians on proper documentation. This involves explaining and interpreting coding and compliance guidelines. When providing such guidance, the most common reply I hear from providers is, “I want it in writing.” An auditing ...