Part B News | Editors' Blog

Who can solve the mystery of the missing level 1 visits?

by: Julia Kyles, CPC Sep 21, 2022

Missing: More than 300,000 services that had been reported with 99201 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.)

Breaking: AMA unveils anticipated E/M changes for facility-based services

by: DecisionHealth Staff Jul 5, 2022

The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023.

Auto-downcoding could mean practices will 'lose revenue, cut provider pay and struggle to make do with less'

by: Julia Kyles, CPC Jun 22, 2022

Practices that aren’t comfortable with the guidelines for office and other outpatient E/M visits may downcode their claims because they mistakenly believe it will protect them from audits. In addition, some private payers may automatically downcode high level claims.

Ready for Round 2? Expect release of 2023 E/M guideline changes this summer

by: Laura Evans, CPC Mar 29, 2022

Practices will be breaking in a new set of E/M guidelines for their visits in a facility starting in January of 2023, according to an AMA official. But you can expect to see the coding and guideline changes sooner than that: CMS wants to have a first look at them by early summer of this year.

CMS clarifies modifier FT rules for critical care services

by: Julia Kyles, CPC Dec 15, 2021

First impressions can be deceiving. The descriptor for modifier FT is a prime example.

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