Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]
In the realm of medical billing and coding, the incorporation of artificial intelligence stands as a pivotal advancement. Its role in healthcare establishments is to optimize billing procedures, thereby mitigating costly errors. Among the array of AI-driven technologies, machine learning and Natural Language Processing (NLP) take the forefront. These tools excel at swiftly and accurately […]
Radiology practices that perform interventional procedures have to be up to date on the use of documentation and coding techniques for evaluation and management (E/M) services. Since these current procedural terminology (CPT) codes in the 99xxx range are less commonly utilized in many radiology practices, identifying circumstances where E/M services are billable and then properly […]
Every year we take direction from the most recent CPT® code book, but it’s important to recognize that it doesn’t have the final say on how to document and code evaluation and management (E/M) visits. For the latest guidance, you need the 2021 CPT® Errata and Technical Corrections. Following the implementation of the updated E/M […]
The new code is expected to be here in October. EDITOR’S NOTE: The following is the broadcast script from Dr. Erica Remer’s segment during Talk Ten Tuesdays, March 16, 2021. One of the highlights of my year, and most definitely in this past year, is participating in the ICD-10-CM Coordination and Maintenance Committee Meeting. It was […]
Below is a listing of questions and answers regarding some of the nuances of billing Evaluation and Management office visits based on time. The new 2021 E/M coding guidelines for office visits (99202-99205, 99212-99215) allow physicians and qualified health professionals (QHP) to choose whether their documentation and code-selection level for E/M services provided is based […]
An ICD-10 Coordination and Maintenance Committee virtual meeting is scheduled for March 9–10, from 9 a.m. to 5 p.m. The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention National Center for Health Statistics (CDC NCHS) have posted tentative agendas on their websites. Stakeholders will present on a […]
For several, it is hard to envision the future of Revenue Cycle Management (RCM) in the Artificial Intelligence (AI) era. How does this technology accelerate the business cycle and affect healthcare back-office day-to-day work? It is unknown when AI will be the industry norm at this stage, but there is some speculation about potential advantages […]
We have received a number of questions from those seeking advice on choosing a coding level when using the new 2021 evaluation and management (E/M) guidelines. The most common questions concern the meaning and interpretation of ideas within the 3 medical decision–making (MDM) categories: the complexity of presenting problem, data, and risk. We are dedicating […]
To select a level of an E/M service, two of the three elements of MDM must be met or exceeded. Q: How do you select an E/M code for an outpatient visit based on documentation of medical decision-making (MDM)? A: Per the 2021 E/M guidelines, effective January 1, providers must select the level of outpatient E/M […]