The code 99417 is invalid for Medicare and MA reimbursement. When the CPT® Guidelines were updated for 2021, one of the options for leveling an office or other outpatient evaluation and management (E&M) service was to use time as the leveling agent. The time thresholds for each E&M office visit…
AMA/CPT® 2021 E&M clarifications are provided for readers and listeners.  Ever since the release of the new 2021 Evaluation and Management (E&M) Guidelines for Office and Other Outpatient Services, ICD10University has been conducting numerous provider and staff educational training sessions through webcasts, articles, and session spotlights on ICD10monitor’s Talk Ten…
Updates are retroactive to Jan. 1, 2021. The following updates have been made via American Medical Association/Current Procedural Terminology (AMA/CPT®) editorial corrections. These corrections (errata) were posted on March 9 (published on April 1)., however, they are retroactive to Jan. 1 Underlined text indicates a change to the language instructions, and…
AMA says these are proposed, not finalized. The American Medical Association (AMA) Editorial Panel met in February to discuss proposed changes to the CPT® Code Book. The formal proposal published on March 5 was a reflection of the discussion, and it raised certain issues that stakeholders will now have an…
Some third-party payers have reimbursed and will continue to reimburse providers for this new CPT code; others won’t. The American Medical Association (AMA) published a new CPT® code on Sept. 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency (PHE).  The code is effective immediately: CPT 99072 – Additional supplies, materials, and clinical…
Effective research leads to correct coding. With the 2021 ICD-10 code updates already in use and the CPT® and HCPCS updates right around the corner, this is a prime time to talk about researching as a core skill for optimal coding. Why are research skills important? Years ago, I worked…
On Sept. 8, the American Medical Association (AMA) released two new codes related to the coding and reporting of COVID-19 testing and management. The additions include one new code in the Pathology and Laboratory sections and one new code in the Medicine section of CPT. A summary of the new…
Choosing a proper office visit code can become confusing unless one understands the rules separating preventative medicine and evaluation and management coding. Preventative medicine codes are meant only for the reporting of asymptomatic patients. In order to assign a preventative code, a comprehensive evaluation must be documented. The scope of…
Reimbursement has not been established at this time. The American Medical Association (AMA) CPT® Editorial Panel has revised one code and created two new codes to provide more specificity for serology laboratory testing.   The codes, which were published on April 10, are effective immediately. Reimbursement has not been established for…
A year before CPT® rules change, payers are expected to crack down on E&M codes. Even as a major change to outpatient evaluation and management (E&M) codes looms next year, a development that would reduce the documentation burden on providers, commercial insurance companies are cracking down this year on E&M…