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Evaluation and management (E/M) code descriptors for office and other outpatient visits will look a lot different in the 2021 CPT® code set. One of the first steps in preparing for this major overhaul is understanding how medical decision making (MDM) and time will affect 99202-99215 in 2021. Quick background: The American Medical Association (AMA), […]
Continue reading...Monday, November 11, 2019
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...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...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...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...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...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...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...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...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. […]
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Monday, January 13, 2020
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