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AMA shakes up prolonged services codes with 2023-effective changes

08/22/2022

Streamlined coding and shorter time requirements for prolonged services are on the horizon for physicians and qualified health care professionals. The pending update to the E/M chapter of the CPT manual, effective Jan. 1, 2023, will replace four prolonged services with two 15-minute codes.

Prolonged E/M visit time chart

08/22/2022

by: Julia Kyles, CPC

While you wait for your 2023 CPT Manual, use this chart to prepare staff for the update to prolonged E/M visits.

Confirm medical necessity of same-day telehealth and in-person encounters

08/22/2022

by: Julia Kyles, CPC

Telehealth visits are still an option under the COVID-19 public health emergency (PHE) waiver even though medical practices are returning to pre-COVID patterns for face-to-face encounters. As a result, it has become more likely that your practice may provide an E/M visit by telehealth and an in-office procedure on the same date of service.

Clarify ICD-10-CM and CPT coding and billing for wound care

08/22/2022

by: Savannah Schmidt

Coding for wound procedures is notoriously difficult, as the process can seem as messy as the injuries themselves. Ensure your staff is prepared to code correctly by fully understanding wound documentation and guidance for reporting wound diagnoses and procedures using ICD-10-CM, CPT and HCPCS Level II codes.

Initial hospital fees take a dive, but subsequent visits spike

08/22/2022

by: Richard Scott

With big changes coming to the inpatient E/M code family in 2023, the fees associated with facility codes 99221-99223 and 99231-99233 are also in flux. Initial visit fees are down, while subsequent encounters are on the rise.

Monkeypox PHE declared; tighten intake protocols, prep for anxious patients

08/15/2022

by: Roy Edroso

U.S. health agencies are now operating under a second public health emergency (PHE) due to the growing number of monkeypox infections in the country. While the declaration shouldn’t change day-to-day life for most providers, you may take it as a cue to increase surveillance and make preparations in case the formerly-rare disease finds its way to your door.

Use these new CPT codes for monkeypox tests, vaccines

08/15/2022

by: Laura Evans, CPC

Practices testing or providing vaccinations for monkeypox will find it easier to bill for those services. The AMA on July 26 issued one new clinical lab test code and two vaccine codes for the virus, effective for use immediately.

Telemedicine or telescam? Heed the warnings in the latest special fraud alert

08/15/2022

by: Julia Kyles, CPC

Physicians and non-physician practitioners who are approached by recruiters from a telemedicine company should read the latest fraud alert from the HHS Office of Inspector General (OIG) before they opt to get involved.

Provider beware: OIG issues 7 signs of a telemedicine scam

08/15/2022

by: Julia Kyles, CPC

Physicians and other qualified health care professionals should check a recruiting telemedicine company’s pitch against the seven signs of a problematic arrangement that the HHS Office of Inspector General (OIG) included in its special fraud alert “OIG Alerts Practitioners to Exercise Caution When Entering into Arrangements with Purported Telemedicine Companies."

Know your rights for medical record access in post-Roe landscape

08/15/2022

by: Roy Edroso

It is expected that prosecutors will seek medical records to support charges against patients they suspect of violating new statutes against abortion, either as evidence of illegal treatment or to determine from notes that the patient sought such services. HIPAA offers some limited protection to practices that don’t want to give them up, and case law suggests the Privacy Law actually prohibits the surrender of protected health information (PHI) in some circumstances.

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