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CMS unveils fresh guidance, answers key questions about G2211

02/05/2024

Make sure documentation supports encounters reported with visit complexity add-on code G2211, remember that you can only report it in conjunction with office/other outpatient E/M visits (99202-99215) and watch for more education materials soon.

Include G2211’s full descriptor in your training

02/05/2024

by: Julia Kyles, CPC

Your practice may call it the visit complexity code, but make sure your coders refer to the full descriptor for G2211 when they perform or report the service. The details will help them understand when and how to report it. For example, it can only be performed in conjunction with office/other outpatient visits (99202-99215).

AI proliferates: Coding and chat remain fertile ground, but watch decision-making

02/05/2024

by: Roy Edroso

If you’ve looked around lately, you were sure to notice a predominant story: The boom in artificial intelligence (AI), which has become big news and has penetrated the health care industry via coding, patient communications, information indexing and even patient care. However, the “intelligence” part of the technology seems not to have developed sufficiently to supplant human decision-making in clinical matters.

CPT 2024: Now you can bill multiple unlisted codes with modifiers

02/05/2024

by: Laura Evans, CPC

In a sign of the expanding role of unlisted CPT codes, practices will be able to append certain modifiers to the codes and even report unlisted codes more than once on a claim in certain circumstances, according to new coding guidelines added to the introduction of the 2024 CPT manual.

Practices reported fewer E/M modifiers with office visits after new guidelines

02/05/2024

by: Julia Kyles, CPC

Providers were less likely to report an E/M modifier with an office/other outpatient visit one year after the new rules for reporting the visits went into effect.

Final prior auth rule sets long lead times — and short payer deadlines

01/29/2024

by: Roy Edroso

With the release of the Interoperability and Prior Authori-zation Final Rule, which CMS dropped on Jan. 17, providers are poised to gain a dose of relief after seeking redress to onerous prior authorization (PA) requirements for years. But it’s not coming as soon as proposed.

Preview updated ICD-10-CM coding guidelines for April 1

01/29/2024

by: Megan Herr

The CDC posted updated FY2024 ICD-10-CM guidelines on Monday, Jan. 22, which included a sequencing update for sepsis due to postprocedural infection.

Use empathy, ‘treatment plans’ to spur provider engagement with compliance

01/29/2024

by: Julia Kyles, CPC

If you struggle to get your compliance message across to physicians and qualified health care professionals (QHP), make sure that you can clearly communicate what you need from the provider and why you need it, and that you do so in a way that make sense to them.

Worried practice buyers will hobble care? Get it in writing during contracting

01/29/2024

by: Roy Edroso

Independent practices that become the target of an acquisition by a larger group or system should take steps to protect their autonomy in the contract stage. A recent survey shows that many physicians employed by large entities are dissatisfied with reduced authority and concerned with the resulting impact on care.

Continue to use the practice address when the place of service is 10

01/29/2024

by: Julia Kyles, CPC

Question: We know the place of service (POS) rules for telehealth services changed this year. Did that change the address we should report in Box 32 of the CMS-1500 form when a patient receives a telehealth visit while at home (POS 10)? We’re not sure if we should use the patient’s home address or continue to report the practice’s address. In addition, our providers occasionally perform telehealth services while they are at home. Which address should we use in that scenario?

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