Feb 27th, 2017
The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient. As of Jan. 1, 2017, CMS has made an exception and will now allow Medicare coverage for non face-to-face prolonged service codes 99358 Prolonged evaluation and management service before ...
Put these OIG compliance efforts on a high priority focus list for your provider. The Office of Inspector General’s (OIG) annual work plan for 2016 outlines significant new areas, as well as ongoing target areas, on which the federal agency will focus its reviews and audits of U.S. Department of Health and Human Services (HHS) ...
Meet criteria to report two new codes for prolonged clinical staff observation services in the outpatient and office settings. Prior to 2016, observation care services provided by clinical staff under the supervision of a physician or other qualified healthcare professional were considered part of office or outpatient services. This year, two new add-on codes are ...
Feb 1st, 2016
Medically unlikely edits add restrictions to these codes. The American Medical Association (AMA) focused on prolonged services for 2016 CPT®. New codes were created and guidelines have been updated. Take note, and apply the changes when reporting these evaluation and management (E/M) services. Report Initial Prolonged Service Once, per Day Although medically unlikely edits (MUEs) ...
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 ...