In Billing
Sep 4th, 2012
If a non-physician practitioner (NPP)—but not a physician—has seen a patient within the last three years, is the patient new or established? Although CPT® consistently uses the term “physician” in the context of determining whether a patient should be considered “new” or “established,” most payers—Medicare payers in particular—don’t apply that instruction literally. For example, Medicare’s definit...
May 1st, 2012
Understand your use of CPT® codes prone to audit review. By Stacy Harper, JD, MHSA, CPC In the current regulatory environment, physicians are searching for ways to minimize audit exposure. Medicare administrative contractors (MACs) frequently review high-level evaluation and management (E/M) services. Review may be based on a random sample, or targeted based on provider ...
Jan 1st, 2012
Successfully apply E/M code modifications in several service categories. With the release of CPT® 2012, evaluation and management (E/M) guidelines have been updated to clarify the meaning of “new” vs. “established” patients, and code use has been modified for several service categories. Here’s what you need to know to apply these changes successfully. Three-year Rule ...
Apr 1st, 2011
AMA’s official guide is now more helpful than ever. Coders always are on the lookout for tips and tools to improve job performance and efficiency. Among the very best resources is one that coders use every day (and may take for granted): The CPT® book. The CPT® book is more than just a list of ...