Behavioral Health – Interactive Complexity Guidelines

Behavioral Health – Interactive Complexity Guidelines

By: Sheila Haynes, Manager Coding & Compliance Defining Interactive Complexity +90785: Interactive Complexity (+90785) is an add-on code utilized for office visits with a psychologist or other mental health professional that are complicated by language, behavior, emotions, mandated reporting requirements or trauma. +90785 is utilized in addition to one of the following primary service codes…

OIG Spotlight – Modifier 25

Modifier 25 is an important Evaluation and Management service medical professionals need to understand. It is used for same-day procedures when services beyond usual pre and post-operation are necessary. Continue reading below for a breakdown and examples of modifier 25! By: Sheila Haynes, CPC Coding and Compliance Manager Pay close attention to billing E/M (office…

Guidelines for Observation Services

Guidelines for Observation Services

By: Sheila Haynes, CPC Observation care is a well-defined set of specific, clinically appropriate services, which include: Ongoing short-term treatment, Assessment, Reassessment These are furnished while a decision is being made regarding whether patients will require further treatment as hospital inpatients or if they are able to be discharged from the hospital. Observation services are…

Telehealth Make Sure Your Practice Is Compliant Before the OIG Comes Calling

Telehealth – Make Sure Your Practice Is Compliant Before the OIG Comes Calling

In response to the COVID-19 pandemic, CMS made several policy changes that allowed Medicare beneficiaries to access a wider range of telehealth services, alleviating some of the burden and risk of an in-person encounter at a healthcare facility. This coverage was established due to the public health emergency (PHE) for COVID-19. The coverage began on…

What to do When a Consulting Doctor Skips the Interprofessional Consults Verbal Report

What to do When a Consulting Doctor Skips the Interprofessional Consults Verbal Report

When a consulting doctor skips the interprofessional consult verbal report, it may cause some confusion when trying to submit an accurate code. There is only one code available for an interprofessional consult done without the verbal report. Continue reading below to learn what code should be used in this scenario! Question: Our doctor frequently forgets…