9 / 7 / 2018
Local Coverage Determinations are extremely important . . . Although coding guidelines, National Coverage Determinations (“NCD”), and other coding resource texts are among the most important resources available...
10 / 25 / 2018
How is Medical Necessity Factored Along with Nature of the Presenting Problem? Do you wish CMS would streamline the Evaluation and Management (“E/M”) guidelines so that everything is black and...
1 / 28 / 2019
In this procedure, the provider performs manual muscle testing to determine the extent and degree of muscular weakness resulting from disease, injury, or disuse. A formal report must be...
1 / 28 / 2019
Shave Removals and Excisions Shave removal of skin lesions (CPT codes 11300–11313) includes the removal of tangential or saucerized skin lesions to a level no deeper than the base...
1 / 28 / 2019
The most recent diagnostic trend among cardiologists is a “new” type of heart problem known as heart dysfunction. When heart dysfunction becomes severe, heart failure can occur. Heart failure...
2 / 6 / 2019
The biggest change and most talked about topic so far with the new 2019 CPT changes is telehealth. Home services have also been expanding in the medical field and what...
2 / 11 / 2019
In 2019, Office of Inspector General (“OIG”) added the review of critical care evaluation and management codes to their work plan for the Office of Audit Services. This review...
2 / 18 / 2019
Documentation requirements for physician Evaluation & Management (“E/M”) visits have not been updated in 20 years. On November 1, 2018, CMS finalized bold proposals that address provider burnout and...
1 / 28 / 2019
On February 2018 CMS released a Final Decision Memo making some “minimal” changes to the National Coverage Determination for ICD’s (20.4). CMS added magnetic resonance imaging (MRI) to the...
9 / 3 / 2019
When reviewing surgeries in order to determine whether an assistant is billable, coders and their providers should always be aware of what is needed in terms of necessity and documentation....