Tag Archive | "E/M"
Highlight E/M, Opioid Use Treatment, PAs, and Single-Disease Care in 2020 MPFS Final Rule
Medicare has released the Medicare Physician Fee Schedule (MPFS) for 2020. Let’s see how it stacks up against some of the proposals from Medicare that we looked at back in August. Expect Separate Payment for E/M Office Levels in 2021 Even though we’re still in 2019, a lot of us have 2021 E/M coding changes […]
Continue reading...Ob-Gyn Coders, Beware This Costly Modifier 24 Myth
Monday, October 21, 2019
Suppose a Medicare patient presents to your ob-gyn practice for a visit scheduled as a follow-up after cervical lesion biopsy, but the doctor also spends time on counseling and coordination of care related to the malignant tumor the biopsy identified. Can you report an E/M with modifier 24 if the visit is during the biopsy’s […]
Continue reading...Part 1: Prepare for CPT® 2020 for E/M and Surgery Codes
Monday, September 9, 2019
The 2020 CPT® code set includes 394 code changes, with 248 new codes, 71 deletions, and 75 revisions, according to the AMA. Let’s start learning those changes by going over what’s new in Category I for E/M and Surgery section codes. Expect Remote and Online to Dominate E/M Changes You probably know there will be […]
Continue reading...MPFS 2020 Proposed Rule: E/M Blended Payment for 2021 Is Dead
Monday, August 5, 2019
Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to revise E/M coding in 2021. But what does the MPFS say about Medicare payment for office/outpatient visits in 2021? Here’s the scoop. Know What to […]
Continue reading...Get a Sneak Peek at CPT® 2020 Additions, Deletions, and Revisions
Tuesday, July 23, 2019
With all the excitement about Medicare and AMA plans for E/M in 2021, don’t forget that the CPT® code set will have changes in 2020, too. The official code set will be out soon, but, in the meantime, here are some hints from the AMA about the changes you’ll have to know for Jan. 1. […]
Continue reading...Modifier 25 Scavenger Hunt! Can You Find These Answers?
Tuesday, May 21, 2019
Keeping up with modifier 25 rules can be intimidating, so let’s add a little fun by seeing if you can unearth the answers to these questions at the locations provided. Ready, set, go! 1. Is This a Separate E/M? You may have the descriptor memorized for modifier 25 (Significant, separately identifiable evaluation and management service […]
Continue reading...Tick-Tock: Understand Why Time Matters for E/M Coding
Monday, April 22, 2019
For E/M, there has been a lot of attention on how the role of time will change in 2021. But what about right now? After this skill sharpener on time in the AMA CPT® E/M guidelines, you’ll have a better understanding of time’s current role in E/M coding. Where to Find AMA CPT® E/M Guidelines […]
Continue reading...$325 Million in Office Visit Underpayments! How Much Is Yours?
Monday, April 8, 2019
Audit discussions often focus on the fear of upcoding and having to hope that repaying the extra amount is the worst of the consequences. But downcoding is another problem area affecting your payments and more. Here’s why you should never purposely downcode your services. Start With a CERT Story Wondering about the $325 million in […]
Continue reading...No More 99201? What’s Coming in 2021 for E/M
Thursday, April 4, 2019
There’s been a lot of buzz about what Medicare has planned for E/M in 2021. One question all that raises is how it will mesh with AMA CPT® coding rules. Here are some hints from the February 2019 CPT® Editorial Summary of Panel Actions about what is in store for the code descriptors and guidelines. […]
Continue reading...Primary Care and Specialists Need to Know These Twin Add-On Codes by 2021
Monday, January 28, 2019
The 2019 MPFS proposed rule discussed potential add-on G codes to represent E/M visit complexity. Here’s a quick look at the intent of the proposed codes and what the final rule had to say about their implementation in 2021. See What Happens to This Code for Specialists In the 2019 Medicare Physician Fee Schedule (MPFS) […]
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Monday, November 11, 2019
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