Category: Coding

Analysis: AMA Responds to E/M Proposal

The AMA sent a letter to the Administrator of CMS on August 27, 2018 with signatures from most of the medical societies and state medical societies with comments on the CMS proposal for the “Patients Over Paperwork” initiative. AMA Loves Paperwork Red… For more, read here: AAPC Blog

E/M Changes May Hit Podiatry and Teaching Attestation

The Centers for Medicare & Medicaid Services (CMS) physician fee schedule proposed rule has some new Part B specific codes for Podiatry Evaluation and Management (E/M) services as well as some modification to Teaching Physician Attestation Rules f… For more, read here: AAPC Blog

CMS Proposes Add-on Codes for E/M Services

The Centers for Medicare & Medicaid Services (CMS) is proposing three new HCPCS Level II add-on codes to be used specifically with evaluation and management (E/M) codes, which would also be revised to create a single rate of $93 for established patients (99212-99215) and a single rate of $135 for new pa… For more, read…
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Changing the Way Medicare Pays Doctors

Besides taking a machete to E/M reimbursement and the way Medicare looks at E/M services, the current administration has proposed some large changes in the way Medicare pays doctors. They have also proposed ways that hospital facilities disclose prices to patients, providing more transpa… For more, read here: AAPC Blog

E/M: 2019 Proposed Physician Fee Schedule – Next Steps

Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s … For more, read here: AAPC Blog

CMS Proposes a Single E/M Payment, Streamlined Doc Requirements

The Federal Register scheduled for publication on July 27, 2018 will include a proposal for a single E/M payment for new outpatient services, and a different single E/M payment for established outpatient E/M services, regardless of the E/M level subm… For more, read here: AAPC Blog

How to Document E/M with Counseling and Coordinating Care

The only case when time may be used as the overriding factor in determining an evaluation and management (E/M) level is when counseling and/or coordinating care dominates the encounter, which means that the time expended on counseling and/or coordinat… For more, read here: AAPC Blog

Modifiers 52 and 53 vs. 73 and 74

Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Disc… For more, read here: AAPC Blog

Audiology Technician Billing

Medicare stipulates precise requirements for billing audiology technicians’ services. As outlined in the Centers for Medicare & Medicaid Services’ (CMS) Transmittal 84 in February 2008, these requirements are distinct from those governing audiolog… For more, read here: AAPC Blog

Coding 3 or 4 Sinuses Using FESS Codes

A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no … For more, read here: AAPC Blog