June 26th 2025
Medicare's new APCM codes empower primary care providers to bill for complex patient management without time constraints, enhancing chronic care delivery.
May 21st 2025
Learn seven proven steps medical practices can use to empower coders, improve coding accuracy, and slash claim denials for a healthier revenue cycle.
January 16th 2025
Company aims to make claims appeals easier and quicker for physicians by having AI do much of the work
January 14th 2025
Behind today's high denial rates lies a fundamental tension – coding requirements grow increasingly complex as coding resources lessen.
January 3rd 2025
Though similar to other specialties, some billing codes are unique for behavioral therapy.
Prescription Drug Management
Does prescribing a new medication qualify as a moderate level decision making?
Problem Visits With Counseling
Can this doc bill for both health maintenance and a problem-based visit on the same day, if counseling is involved?
Do You Have a Business Plan for Your Practice?
Today's practice managers must plan proactively for the new year - finding new ways to cut costs and improve efficiencies.
Coding for Observation Services
Coding for observation services can be confounding. Currently, CPT and CMS disagree on which code to report on the second day of observation. In 2011, that is changing.
Physician Presence Matters in Outpatient Setting
Can this physician bill for monitoring OB patients in the outpatient setting if he is physically not present?
Medical Consult - Dead or Alive?
Can you still use the consult code for Medicare and private payers?
Smoking Cessation Help in 2011
New Medicare coverage for smoking cessation counseling
Getting Paid for Pulse Ox
This physicians wonders why he doesn't get paid for performing a pulse ox.
E&M Guideline Updates
The 1995 and 1997 CMS guidelines for E&M services are still topical.
ICD-10 '411'
How many new codes will there be in the ICD-10 CM and PCS code sets?
Mixing Exam Types?
Can this provider choose elements from both a multisystem and single organ system exam?
Patients' Paperwork
Even though there is a CPT code for completing patient forms, many payers do not reimburse physicians for that service.
Billing for Infusion Services
This physician is billing for blood draws in the hospital outpatient setting.
NPP Versus Physician Visit
Billing for a patient seen on the same day, in the same group, by two different providers.
Locum Tenens In, Provider Out
How should this physician bill for a locum tenens provider?
Hospitalist Admit Billing
This physicians wants to know who should bill for a hospital admission: the surgeon or hospitalist?
Coding: Preventive services; ICD-10 readiness; new ABN form
Medical coding guidance on prevention planning; the ICD-10 transition; ABN advice; and more.
ER Codes
Now that consult codes are gone, how does this doc code for visiting her patient in the ER?
‘Detailed Exam’ Debate
How many systems need to be documented for a detailed exam?
Decision Making for Established Visits
While medical necessity is the primary criteria for payment, medical decision making counts too
Critical Care Code
Meeting the requirements for critical care in the office
Complaint Complexity
Chief complaint or history of present illness?
Coding Profiles for OB/GYN
Medicare's E&M codes by speciality
HCPCS Code for Suture Removal
A reader responds to coding for suture removal
Coding for Pre-Op Exam
This practice was erroneously told to use the -56 modifier when they code surgical pre-ops
Capturing All the Work
What should you do when RVUs don't paint a true picture?
Billing Massage Chair Use
Is there a CPT code for use of a massage chair?
Billing for Vitals Recordings
Billing for medical assistant's work
Billing for Hospitalists
Billing as both a hospitalist and private physician
Billing a Hospital Admit
How to bill for a successive office visit and hospital admission