Jul 24, 2016 | Medical billing basics
(Office or Other Outpatient Setting) If the total direct face-to-face time equals or exceeds the threshold time for code 99354, but is less than the threshold time for code 99355, the physician should bill the evaluation and management visit code and code 99354....
Jul 22, 2016 | Medical billing basics
Clinic/Center-Federally Qualified Health Center (FQHC) Bill the encounter using procedure code T1015 with the appropriate rate on the first detail line. Providers are required to list all the CPT/HCPCS services provided during the encounter priced at zero dollars on...
Jul 19, 2016 | Medical billing basics
Prolonged Services With Direct Face-to-Face Patient Contact Service A. Definition Prolonged physician services (CPT code 99354) in the office or other outpatient setting with direct face-to-face patient contact which require 1 hour beyond the usual service are payable...
Jul 17, 2016 | Medical billing basics
A. Requirement for Physician Presence Home services codes 99341-99350 are paid when they are billed to report evaluation and management services provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in...
Jul 15, 2016 | Medical billing basics
Who must pay an application fee? Institutional/facility-type providers newly enrolling in Medicaid or those...
Jul 10, 2016 | Medical billing basics
Home Care and Domiciliary Care Visits Physician Visits to Patients Residing in Various Places of Service The American Medical Association’s Current Procedural Terminology (CPT) 2006 new patient codes 99324 – 99328 and established patient codes 99334 – 99337(new...
Jul 7, 2016 | Medical billing basics
HCPCS Modifier Description H2011 Community Crisis Supports (1 unit = 15 min) H2015 Comprehensive Community Support Services; per 15 minutes (24-hour/day unavailable under hourly services) for participants who live in their own home or apartment or live with a...
Jul 6, 2016 | Medical billing basics
In a hospital inpatient situation involving one physician covering for another, if physician A sees the patient in the morning and physician B, who is covering for A, sees the same patient in the evening, contractors do not pay physician B for the second visit. The...
Jul 3, 2016 | Medical billing basics
When a hospital inpatient or office/outpatient evaluation and management service (E/M) are furnished on a calendar date at which time the patient does not require critical care and the patient subsequently requires critical care both the critical Care Services (CPT...
Jun 30, 2016 | Medical billing basics
Urinary and Male Genital Systems (Codes 50010 – 55899) A. Cystourethroscopy With Ureteral Catheterization (Code 52005) Code 52005 has a zero in the bilateral field (payment adjustment for bilateral procedure does not apply) because the basic procedure is an...
