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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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CPT copyright 2012 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The responsibility for the content of any “National Correct Coding Policy” included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse or interpretation of information contained in this product.