Medical Decision Making: Drug Therapy Requiring Intensive Monitoring for Toxicity

There are often questions and confusion on what is included and acceptable when choosing “Drug therapy requiring intensive monitoring for toxicity” in the Medical Decision-Making Risk category for Evaluation and Management coding. This article reviews the definition and guidelines as provided by CMS and their Medicare Administrative Contractors (MACs). Risk: High MDM – Drug therapy…

Routine Medical Supplies Coverage and Guidelines

Routine Medical Supplies Coverage and Guidelines

By: Sheila Haynes – Coding and Compliance Manager Correct coding and code definitions apply in all circumstances and to all provider types. Whenever a code is billed which includes another service or supply, whether by code definition or by coding guidelines, the included service or supply is not eligible for separate reimbursement. Supplies For Professional…

Setting the Stage for Success

Medical billers, coders, compliance officers, practice managers, and other healthcare business professionals joined AAPC on Dec. 9 for the first day of ELEVATE. The two-day leadership conference is dedicated to career development and helping healthcare business professionals learn what they can do to enhance their skill sets and advance their careers. The virtual event features…

Spinal Injection Procedures

Spinal Injection Procedures

The report below describes spinal injection procedures in detail, noting how many of these procedures are bundled into one code. Continue reading below to learn more! Do you have a complicated surgery case that needs help with coding? RT Welter would love to help! Please upload the operative note by clicking on the link below.…

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…