April 30th 2021
2021 has brought about the most extensive changes to CMS’s Evaluation and Management (E&M) guidelines since 1997.
January 12th 2021
Extensive revisions aim to prioritize patient care information, resource-based reimbursement, and lessening the need for audits.
August 24th 2020
Why practices should not fear new coding requirements
February 3rd 2020
CMS rules to simplify E/M coding and reemphasize patient narrative.
January 15th 2020
Practices are using E&M codes to bill for non-physician educational visits, but is this ok?
Managing your payer mix to improve your bottom line
Payers don’t dole out equal pay for equal work, so it benefits your physician practice to understand who pays what (so you can negotiate more).
Coding for preventive care and chronic care management
Coding expert Bill Dacey clears up some confusion about split billing and combination visits.
Required documentation for 99214 coding
In order to justify the Level 4 E/M visit, make sure you have recorded all necessary information-and clearly label it for the payer auditor to easily find.
Medicare on medical necessity and more on time-based coding
How to code varies on the circumstances. Many coding scenarios are determined by context-not absolutes.
A legal look at the 2019 Physician Fee Schedule
Proper billing and coding under CMS’s final rule is important not only for reimbursement but also to avoid potential lawsuits.
Coding for wellness visits and time-based statements
This month’s coding questions look at how timing plays a role with annual checkups and the stipulations that must be met for coding by time.
The real cost of falsifying claims
A recent $65M False Claims Act settlement highlights physicians' responsibility to provide the best care as well as correctly document and appropriately code it.
Coding for patient care outside the office
How to meet patients wherever they are-and ensure you can get paid for telehealth and virtual check-ins.
The CMS proposed rule: A fool’s bargain
Decreasing documentation requirements leads to decreasing reimbursement for the same amount of clinical work.
Tricky coding diagnoses
Sometimes, the difficulty in treating patients lies in knowing how to code their ailments.
‘Patients over Paperwork’ or bait and switch?
Coding expert Bill Dacey reacts to CMS’s 2019 proposed Medicare Physician Fee Schedule that would collapse office Evaluation and Management code levels-and payment rates.
Thoughts on CMS’s dramatic proposal for E/M guidelines
Here are five reasons why CMS’s proposed Physician Fee Schedule for Evaluation and Management guidelines might improve patient care.
Coding for care on the clock
Take time to clarify the midpoint rule, review CMS’s proposed guidelines for Evaluation & Management, and ask why you’re being instructed to change billing codes.
3 easy steps to identify undercoding
Untap hidden revenue and stop leaving money on the table by reviewing your Evaluation & Management coding.
You Should Worry about Medical Coding Guidelines Changing
E&M coding guidelines are finally changing after 20 years, but don't celebrate yet. These changes may be worrisome to practices
11 Common Coding Questions (and Their Answers)
Inaccurate billing and coding can have a direct and negative impact on a practice's bottom line. What are some common coding queries?
Coding E&M for Preventive Services
This month's coding column looks at whether or not you can count addressing routine chronic conditions without a change in plan of care as E&M.
Understanding Global Billing in a Group Practice
This month's coding questions tackle whether physicians in the same group practice in the same specialty have to bill as a single doctor.
Upcoding vs. Downcoding: Know the Difference
New Versus Established; Split/Shared E&M; 92060 Requirements
Answers from our coding expert on questions regarding new versus established patients; split/shared E&M; 92060 requirements; and same-day admit/discharge.
Problem Focused Exam; Scribe Services
Our coding expert discusses coding for unspecified diagnosis at the time of encounter; a problem-focused exam; and scribe services.
Benchmarking Resources; 92225 vs. 92226
Answers from our coding expert on questions regarding benchmarking resources; 92225 vs. 92226; procedures in visit notes; and chronic care management.
New Surgical Coding Modifiers Replace Modifier -59
Over the summer CMS added four new modifiers that will require a much greater degree of specification when coding surgical procedures.
Attending Telephone Consults, Advanced Practitioner Consults
Get coding guidance on resident consultation via telephone; discharging patients; antepartum care; and more.
Coding Questions: Resident Billing Without a Teaching Physician
Is there any "primary-care setting" where a resident may bill the office visit without a teaching physician, other than in the primary-care exception?
IUD Insertion; Established Visit; Coding for Vaccines
Coding questions? We've got the answers.
Abandoning Self-Audits at Your Medical Practice is a Mistake
A recent court case illustrates why physicians need to be vigilant in reporting incorrect claim submissions every time, all the time.
Multiple Procedure Payment Reductions; Error with Code 764.95
Five Common Coding Errors in Medical Practices
Medical practices are concentrating on critical changes as part of the ACA but it is important not to lose focus on the basics of coding.
Requests for Consult; Global Preventive Medicine Codes
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