Tag: E/M Codes

cigna-updates-modifier-25-reimbursement-policy

Cigna Updates Modifier 25 Reimbursement Policy

Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
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2023-Telehealth-Service-Codes

The 2023 Telehealth Service Codes Physicians Need to Know

Question: Could you kindly provide us with the updated telehealth services codes for the year 2023? Response: Regarding Medicare Telehealth Services for the year 2023, the Centers for Medicare and Medicaid Services (CMS) are introducing fresh Healthcare Common Procedure Coding System (HCPCS) codes to the compilation of Medicare telehealth services. More precisely, the subsequent HCPCS […]
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AMA-Releases-2023-CPT-Errata

AMA Releases More 2023 CPT® Errata

E/M, Gastro, and Lab Coders, take note. The American Medical Association (AMA) announced some last-minute corrections to the CPT® code set effective Jan. 1, 2023. Add these to your code book, along with the previously released corrections, to ensure you start the year off right with accurate codes and guidelines. Evaluation and Management (E/M) In […]
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take-the-complexity-out-of-behavioral-health-coding

Take the Complexity Out of Behavioral Health Coding

The secret to ensuring both proper payment and compliance is in the details. Why is mental health coding so complex? Laurie Bouzarelos, MHA, CPC, asked and answered that question in her presentation “Coding and Billing for Psychiatry and Outpatient Mental Health Providers” at AAPC’s virtual HEALTHCON 2022, March 27-30. Bouzarelos manages to take much of […]
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are-you-using-modifier-25-correctly

Are You Using Modifier 25 Correctly?

Oftentimes a patient’s “Oh, by the way …” comment turns an encounter that was scheduled as a preventive medicine visit or a minor office surgery into something more involved. When the provider goes above and beyond the physician work normally associated with a billable service or procedure, you may be able to report the separate […]
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cms-updates-hcpcs-level-ii-for-q2

CMS Updates HCPCS Level II for Q2

Medical Coding Updates and Insights Unveiled Effective April 1, 2022, the HCPCS Level II code set, which is employed to record medical services and provisions, will encompass the integration of 37 novel codes. Furthermore, the second quarter revision encompasses the elimination of five codes and a refinement of the description for one modifier. Lay Terms […]
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medical-decision-making-and-coding

Medical decision making and coding

MDM elements during a preventive visit Q: Is it appropriate to count laboratory tests and other tests ordered during a preventive medicine service (99381-99397) visit in medical decision making (MDM) selection? No, because the 2021 revisions to the E/M office or other outpatient MDM do not apply to codes 99381-99397 (preventive services). These codes are […]
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coding-audits-101-how-physicians-can-prepare

Coding audits 101: How physicians can prepare

  You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You provide excellent care for your patients and achieve great outcomes. […]
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