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When coding office or outpatient visits based on time, it is essential to consider the total minutes a physician or qualified healthcare professional spends on various activities, including time spent updating the patient’s medical record. These activities must take place on the same calendar date as the face-to-face encounter. Key Points about Time-Based Coding: Time-based … Read more
Basics of 2025 Telemedicine Codes The 2025 CPT manual introduces 16 new telemedicine codes designed for real-time encounters, which are divided into those conducted via synchronous audio-video connection and audio-only connection. These codes mirror the structure of office and outpatient evaluation and management (E/M) codes. It is essential to note that the services must be … Read more
The 2025 expansion of CPT (Current Procedural Terminology) codes is poised to bring significant changes to primary care practices, with the introduction of 270 new codes, 38 revisions, and 112 deletions. These updates, effective January 1, 2025, are crucial for providers to review in advance to ensure timely reimbursement. On September 1, the American Medical … Read more
In January 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance regarding the implementation of HCPCS add-on code G2211. This code is designed for office and outpatient (O/O) evaluation and management (E/M) visits that are inherently complex due to the medical care required. G2211 applies when care involves continuous collaboration for a patient’s … Read more
As modifier -FS approaches its third year of active status, it’s important to understand the correct application of this modifier, which dictates payment for split/shared E/M visits. Since its introduction by CMS in January 2022, the modifier has become crucial for accurate billing, helping to prevent overpayments, underpayments, and compliance issues. Here are key tips … Read more
The Centers for Medicare & Medicaid Services (CMS) has finalized several changes that significantly expand the scope of behavioral health services, incorporating new coverage for digital treatments and crisis intervention codes. These updates aim to enhance access to behavioral health care, especially in digital and remote settings, and address evolving patient needs. Key Updates to … Read more
Since January 2021, healthcare providers have had the flexibility to select the level of evaluation and management (E/M) service based on either the complexity of medical decision-making (MDM) or the total time spent on the date of the encounter. This flexibility allows providers to choose the method that best reflects the care provided during a … Read more
In the world of medical billing and coding, precision is crucial. Healthcare providers must navigate a complex landscape of codes and regulations to ensure proper reimbursement for services rendered. One common issue that arises is the N822 remark code, which indicates that a claim has been denied due to missing procedure modifiers. In this article, … Read more
Navigating the complexities of medical billing can be challenging, particularly when dealing with various remark codes. One significant code to be aware of is the N219 remark code, which indicates that the payment for a claim is based on the allowed amount set by a previous payer. This article will explore the implications of the … Read more
In the realm of medical billing and coding, remark codes play a vital role in communicating important information about claim processing. One such code is N381, which serves as an alert to healthcare providers regarding restrictions and payment information linked to their contractual agreements with insurers. In this article, we will explore the N381 remark … Read more