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6 / 27 / 2024

Psychotherapy Documentation Guidelines

By
Lori Carlin &
Alysia Delozier
Before we discuss documentation guidelines, let’s define psychotherapy. Psychotherapy, also known as talk therapy, is a type of therapy during which the provider uses a series of techniques to...
6 / 25 / 2024

Three Medicare Preventive Services That Can Be Performed Via Telehealth

By
Lori Carlin &
Angela Wood
If you haven’t already, you should utilize the Medicare Preventive Services education tool from The Medicare Learning Network! Not only does it lay out all of Medicare’s preventive services...
6 / 13 / 2024

Telehealth Updates – CMS 2024 Final Rule

By
Lori Carlin &
Angela Wood
Since 2020, telehealth services have seen many changes, but there were some significant changes to telehealth in the Centers for Medicare and Medicaid Services (“CMS”) 2024 Physician Fee Schedule...
5 / 30 / 2024

Just When We Thought It Was Safe to Go Back in the Water: The Transforming Episode Accountability Model (TEAM) Has Been Released

By
Amy Crenshaw-Pritchett
Introduction On April 10, 2024, The Centers for Medicare and Medicaid Services (CMS) released the proposed Inpatient Prospective Payment System (IPPS) for Fiscal Year (FY) 2025. Within the release...
5 / 16 / 2024

CMS Finalized the Payment Updates for 2025 Medicare Advantage Programs – What Now?

By
Amy Crenshaw-Pritchett
On April 1, 2024, the Centers for Medicare and Medicaid Services (“CMS”) finalized their Calendar Year (CY) 2025 rates for Medicare Advantage (“MA”) and Part D prescription drug programs....
4 / 23 / 2024

2023 Evaluation and Management Guideline Changes

By
Angela Wood
In January of 2021, the American Medical Association (AMA) released new evaluation and management (E/M) guidelines that simplified the documentation requirements for outpatient E/M services. On the heels...
4 / 23 / 2024

Visit Complexity Add-On Code G2211 FAQs

By
Lori Carlin &
Angela Wood &
Alysia Delozier
Recently, we have been getting questions about the new Healthcare Common Procedural Coding System (“HCPCS”) code G2211 (Visit complexity inherent to evaluation and management associated with medical care services...
4 / 17 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Bonus Article – Billing Bilateral Procedures

By
Lori Carlin &
Angela Wood
If you have questions about how to properly bill Medicare for bilateral procedures, the National Correct Coding Initiative (“NCCI”) policy manual has your answers. Starting on page 30 of...
4 / 3 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Three – Add-On Code Edits

By
Lori Carlin &
Angela Wood
In this series of articles on the National Correct Coding Initiative (“NCCI”) Policy Manual, we have discussed procedure to procedure (“PTP”) edits and medically unlikely edits (“MUE”), but were...
3 / 26 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Two – Medically Unlikely Edits

By
Lori Carlin &
Angela Wood
In part one we discussed procedure to procedure (“PTP”) edits. In this article we will discuss Medically Unlikely Edits (“MUEs”). The Centers for Medicare and Medicaid Services (“CMS”) defines...