QUESTION: I’m pretty nervous about the significant changes to the Evaluation and Management (E/M) codes being made soon. The 2020 CMS Physician Fee Schedule goes into effect January 1, 2020, Does it contain the changes? ANSWER: The 2020 Medicare Physician Fee Schedule Final Rule confirms that the E/M code changes completely take effect in 2021. […]
Determining whether a patient is new or established shouldn’t be complicated — but coding CPT 99201-99215 office visits is oftentimes not so clear. Miscoding these E/M visits, however, can cost you thousands of dollars each year in lost revenue. In fact, selecting an established patient when you should have billed a new patient office visit […]
If you don’t have time to comb through the 2020 Medicare Physician Fee Schedule Final Rule, you’re not alone. Most physicians and staff are simply too pressed for time to figure out exactly what parts of the rule are relevant to their practice and specialty. If that’s the case — don’t worry. We’ve sussed out […]
QUESTION: Can you bill CPT Code 99211 for a blood pressure check by the nurse? The patient did not see the doctor. – Anonymous, Salt Lake City, UT ANSWER: You may bill CPT code 99211 for a blood pressure evaluation for an established patient whose physician requested a follow-up visit to check blood pressure. CPT […]
Coding infusions is far from run-of-the-mill, and if you don’t get it right, you’ll likely see reduced — if not denied — claims. One of the key concepts when reporting this service is understanding the type of infusion you’re providing. Get it right, and your claim sails through, but get it wrong, and you’ll be […]
Too often, a patient schedules a visit for one reason, and then brings in a laundry list of other, unrelated health issues and concerns to discuss with the doctor. You may think this is just a cost of doing business at your practice, but you can be reimbursed for this extra time … if you […]
According to a May 2014 report based on 2010 data, HHS is claiming Medicare overpaid $6.7 billion in E/M payments to providers. The Inspector General’s report, released on May 29, 2014 estimates that 21% of the $32.3 billion spent on E/M services in 2010 are overpayments. This data is based on 657 Medicare claims. Although […]
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