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Coding

Coding

G2211

Collect More E/M Pay in 2024 With New Add-on Code G2211

It’s not often that CMS presents coders with a way to collect more for E/​M visits, but in 2024, you’re about to benefit from a relatively new add-on code that allows you to do just that with the implementation of G2211 effective January 1. Discover the facts you must know if you want to collect […]
Radiology coding

3 Radiology Coding Best Practices to Keep Imaging Pay Flowing

Providers perform diagnostic radiology services not only to evaluate a patient’s condition, but also to follow up on progress or determine whether a treatment is working. Coding these services sometimes seems straightforward, but it’s easy — and dangerous — to get complacent about radiology coding. Check out three tips that can help you ensure that […]
Modifier 25

3 Modifier 25 Best Practices to Keep Your E/M Pay Flowing

Every minor procedure your providers perform includes an inherent evaluation and management (E/​M) portion factored into the reimbursement for it. But when you go beyond that cursory E/​M work, you should be able to collect for the extra time your provider spends — and that’s where modifier 25 comes in. Although modifier 25 represents a […]
Telehealth services

CMS Updates Telehealth Rules, Approves Using E/M Code G2211

If your practice has been eagerly awaiting word from CMS about how Medicare payments would be calculated in 2024, the wait is over. The agency released its 2024 Physician Fee Schedule Final Rule on November 2, and the provisions include a 3.4% lower conversion factor of $32.7375, updates to the telehealth rules, approval of using […]
Incident to billing

3 Examples Help Strengthen Your Incident To Billing Skills

When a nonphysician practitioner (NPP) sees a Medicare patient at your practice, you can typically plan to collect a reduced rate compared to what a physician would receive for the same service. But one way you can avoid accepting 15% less pay for the same service is by utilizing incident to billing — if you […]
CPT 2024

CPT 2024: Check New RSV, COVID-19 Immunization Codes

If your practice likes to get ahead of the curve, now’s the time to start getting to know the 2024 CPT codes. The American Medical Association (AMA) released the updated code set on September 8, revealing 230 new codes, 49 deletions and 70 revisions. Take a look at some of the highlights you’ll find as […]
Urine drug testing

3 Compliance Tips to Follow When Billing Urine Drug Testing

Because urine drug testing (UDT) codes don’t bring in massive reimbursement on a per-claim basis, many practices think the OIG isn’t paying much attention to these services — but that misconception can get you into trouble. In fact, the OIG frequently comes after practices that incorrectly report drug testing services, not only asking for refunds, […]
JZ modifier

Avoid Oct. 1 Denials: Report Modifiers JW and JZ Properly

When CMS debuted the JZ modifier last November, the agency gave practices until July 1 to start using it, allowing for a brief period so billers could get to know how the modifier worked. Unfortunately, some practices aren’t yet using modifier JZ, which could mean trouble starting in October—at which point Medicare payers will start […]
Time-based coding

9 Things You Can Count Toward E/M Time (and 4 You Can’t)

When the office-based E/​M coding guidelines changed in 2021, coders faced a huge learning curve. It involved transitioning from selecting the right code based on history, exam and medical decision making (MDM) to choosing the most appropriate code based on either time spent or MDM only. And while coders have weathered the change by now, […]
Chronic pain

G89 Series: How to Select the Best Chronic Pain Diagnosis Code

When CMS introduced chronic pain management codes G3002 and G3003 effective Jan. 1, practices rejoiced at the new options. But coverage for these codes, as is the case with all medical claims, hinges on medical necessity. And the best way to demonstrate that is to report the most accurate ICD-10-CM codes. To correctly identify the […]