Time Threshold E/M Billing And CPT ® Coding Reference Tables.
Evaluation and management CPT ® coding isa set of a highly complex rules that must be mastered for physicians to accurately submit charges for services provided. Make sure to review the AMA CPT 2016 Standard Edition as the definitive authority on codes. I am not a certified coding expert, but I have studied this stuff for years and have a great grasp on the E/M process. Despite that, the rules are so complex that after a decade of hospitalist work, I still carry a bedside E/M reference card (see at bottom of post) with me at all times to make sure I am submitting the correct E/M charge ...
Source: The Happy Hospitalist - November 24, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
" Discussion Of Case With Another Health Care Provider " and CMS Definition of Health Care Provider
Trying to code everyevaluation and management (E/M) visit correctly, every time, is difficult. Why? Because Medicare, by default, established rules which were vague and open to interpretation. While not a product of CMS, the Marshfield Clinic audit tool is used by many Medicare carriers to help define the medical decision making component of the E/M rules as low, medium or high. These rules are complicated. After a decade, I still use a bedsideE/M reference card I created as a reference to try and help me get my correct level of care every time.In the medical decision making (MDM) component of E/M coding there are th...
Source: The Happy Hospitalist - September 3, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
"Discussion Of Case With Another Health Care Provider" and CMS Definition of Health Care Provider
Trying to code everyevaluation and management (E/M) visit correctly, every time, is difficult. Why? Because Medicare, by default, established rules which were vague and open to interpretation. While not a product of CMS, the Marshfield Clinic audit tool is used by many Medicare carriers to help define the medical decision making component of the E/M rules as low, medium or high. These rules are complicated. After a decade, I still use a bedsideE/M reference card I created as a reference to try and help me get my correct level of care every time.In the medical decision making (MDM) component of E/M coding there are th...
Source: The Happy Hospitalist - September 3, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
Incident To And Split Shared Services Billing With Non-Physician Practitioners (NP and PA) Explained.
This lecture discusses incident to and shared/split services definitions and coding scenarios with physicians and non-physician practitioners (NPPs). I think it's important to understand how the Centers For Medicare& Medicaid Services (CMS) defines these terms before proceeding on with discussion of detailed coding scenarios. One Medicare carrier (link no longer active) provide a brief descriptions of both terms as well as a few scenarios from a Q&A session.Incident to billing is when a service is provided in an office setting by someone other than the physician. However, if the situation meets the g...
Source: The Happy Hospitalist - August 21, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
How Much Is One RVU Worth For Medicare Patients 2017? A Detailed Explanation.
UPDADTE 2017: One RVU is worth $35.8887 for 2017 according to thisAMA site.UPDATE 2016: According tothis document on Office of the Federal Registrar regarding CMS-1631-P (on table 60 near the bottom of the document) the corrected 2016 RVU conversion factor for one RVU is $35.8043, not the previously reported $35.8279. This RVU conversion factor is in effect from January 1, 2016 through December 31, 2016.UPDATE for 2015: According to CMS documents (Medicare Physician Fee Schedule Final Rulepage 534), the 2015 RVU conversion factor for one RVU is $35.8013 from January 1st, 2015 through March 31st, 2015.&n...
Source: The Happy Hospitalist - August 6, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
Can a Hospital Force a Patient To Go To a Nursing Home (SNF) Or Prevent You From Leaving One?
Many elderly patients get admitted to the hospital with profound weakness due to their acute and chronic medical conditions. Many of them will leave the hospital with profound weakness from their acute and chronic medical conditions (and unfortunately without a palliative care consult). In many situations, these patients will be too weak to take care of themselves. They will need extra help with their activities of daily living either from family or from trained home health care representatives. Patients who cannot safely return to the community often need to transition through a nursing home (with skilled nurses) bef...
Source: The Happy Hospitalist - July 21, 2012 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
