Internal Medicine Coding Alert
New Category Tracks Office Performance
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Question: I heard that there's a new code section coming in CPT 2004. What is it and how will we use it? - Answers for You Be the Coder and Reader Questions were reviewed by Kathy Pride, CPC, CCS-P, a coding consultant for QuadraMed in Port St. Lucie, Fla.; and Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for RCH Healthcare Advisors LLC, a Fort Lauderdale, Fla.-based healthcare consulting company.
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Answer: Although CPT 2004's new section, Category II codes, may give you a chance to track E/M components and office performance, don't expect to see additional reimbursement.
CPT's new Category II adds supplemental tracking codes for performance measurements, and insurers don't pay for these codes. AMA adds this section to comply with HIPAA regulation requirements.
These codes will not affect reimbursement. Instead, AMA hopes that these codes will facilitate data collection about quality of care, and some of the codes may relate to healthcare professionals' compliance with state or federal law. You should be aware of the following:
AMA will release new codes for this section semi-annually, and you can find them on the AMA/CPT Web site
The Category II codes that will be effective Jan. 1, 2004, are:
Internal Medicine Coding Alert
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New Category Tracks Office Performance
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