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Coding Quandry
Chronicity of the Condition
Question: One point of clarification I've wondered about. What defines the chronicity of the condition? Is it if it's lasted more than one year already for the patient or is it if we know that it's going to last more than a year even if it's only lasted a few months?...
Shave Biopsy
Question: When I am performing a shave biopsy, I append diagnosis code D48.5 to the service. My coder is telling me that it is incorrect, and I should use D49.2 instead. Who is correct? Answer: The coder is correct on this one. D48.5 is Neoplasm of Uncertain...
Chronicity of the Condition
Question: One point of clarification I've wondered about. What defines the chronicity of the condition? Is it if it's lasted more than one year already for the patient or is it if we know that it's going to last more than a year even if it's only lasted a few months?...
Shave Biopsy
Question: When I am performing a shave biopsy, I append diagnosis code D48.5 to the service. My coder is telling me that it is incorrect, and I should use D49.2 instead. Who is correct? Answer: The coder is correct on this one. D48.5 is Neoplasm of Uncertain...
Principal Care Management Coding
In CPT this year, there are new Category I codes for Principal Care Management (PCM). CPT CODE DESCRIPTION #•99424 Principal care management services, for a single high-risk disease…; first 30 minutes provided personally by a physician or OQHCP, per calendar month...
Telehealth and the OIG Work Plan
The pandemic and the public health emergency (PHE) it brought along with it, have changed how health care is delivered. Commercial payors have been more amenable to paying for telehealth services in prior years. Due to the pandemic, CMS decided to relax its...
Final Rule for Physician Fee Schedule and Other Medicare Policies Posted
CMS issued a final rule on the Medicare Physician Fee Schedule and some other policies that are slated to start on or after January 1, 2021. The 1,994 page document has a lot of information on many different policies, so a few important ones will be highlighted here,...
Webinar: 2021 E/M Changes
Presenter: Betty Hovey, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I Time: 1:00 hour Cost: FREE to all BC Advantage Magazine subscribers CEU: 1.0 CEU approved Must complete before 11/22/2021 Objective: This presentation will provide excellent information about the...
2021 E/M Changes: Are You Ready?
The last big change for Evaluation and Management (E/M) coding was in 2010 when Medicare stopped accepting consultations. Not since 1997 have the guidelines gone through such a big adjustment. Due to the pandemic, though, many practices are not prepared for this...
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Principal Care Management Coding
In CPT this year, there are new Category I codes for Principal Care Management (PCM). CPT CODE DESCRIPTION #•99424 Principal care management services, for a single high-risk disease…; first 30 minutes provided personally by a physician or OQHCP, per calendar month...
Telehealth and the OIG Work Plan
The pandemic and the public health emergency (PHE) it brought along with it, have changed how health care is delivered. Commercial payors have been more amenable to paying for telehealth services in prior years. Due to the pandemic, CMS decided to relax its...
Final Rule for Physician Fee Schedule and Other Medicare Policies Posted
CMS issued a final rule on the Medicare Physician Fee Schedule and some other policies that are slated to start on or after January 1, 2021. The 1,994 page document has a lot of information on many different policies, so a few important ones will be highlighted here,...
Webinar: 2021 E/M Changes
Presenter: Betty Hovey, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I Time: 1:00 hour Cost: FREE to all BC Advantage Magazine subscribers CEU: 1.0 CEU approved Must complete before 11/22/2021 Objective: This presentation will provide excellent information about the...
2021 E/M Changes: Are You Ready?
The last big change for Evaluation and Management (E/M) coding was in 2010 when Medicare stopped accepting consultations. Not since 1997 have the guidelines gone through such a big adjustment. Due to the pandemic, though, many practices are not prepared for this...