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Issue #5 - January 2, 2013

Coding/Billing Tips and Resources

Four Rules to Report POS Correctly

The Centers for Medicare & Medicaid Services (CMS) has updated its policy on place of service (POS) coding. The revisions are more about "housekeeping" than substantive change, but with the Office of Inspector General (OIG) continuing to target POS assignments as a problem area, there's no time like the present to perfect your POS coding.


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2013 Psychotherapy Codes Better Describe Care
By Cindy Harms, M.Ed., CPC-I, CPC-H

In 2013, CPT® codes for psychotherapy are changing to more accurately describe the practice of psychology:

  • Codes for diagnostic evaluation and psychotherapy can be used in any setting; separate codes are no longer available for outpatients and inpatients.
  • Add-on codes should now be used to describe interactive complexity services and pharmacologic management.
  • Codes are now available to describe psychotherapy for crisis situations.

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Medicare Therapy Services Require Level III Codes/Modifiers in 2013

If you report outpatient therapy services for Medicare patients, get ready for a change. Beginning Jan. 1, claims filed at specified points during treatment must include a G code to describe certain functional limitations the patient may have, as well as a modifier to describe the extent of that limitation.

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Gastric Band Adjustments Update

In November, we reported that Medicare Part B Carrier Palmetto GBA was instructing coders to report an evaluation and management service (99213) for gastric restrictive device band adjustments outside of the global period. Since that time, Palmetto has updated its policy, and now asks that such adjustments be coded using 43999 Unlisted procedure, stomach.

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In This Issue
Report POS Correctly
2013 Psychotherapy Codes
Medicare Therapy Services
Gastric Band Adjustments

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