Critical Care Services

By: Sheila Haynes, CPC Coding and Compliance Manager Guidelines for Use of Critical Care Codes (CPT codes 99291 and 99292) To reliably and consistently determine that critical care services, rather than other evaluation and management (E/M) services, are medically necessary the following review criteria must be met in addition to the Current CPT Manual definitions:…

Evaluation & Management Updates and CPT Code Changes Effective for 2022

After a year of getting accustomed to the new Evaluation and Management guidelines that went into effect on January 1, 2021, the AMA has provided some much-needed clarification around the Medical Decision Making elements as well as what activities are “not” counted when reporting time as the key criterion for code selection Medical Decision Making…

Medicare Guidelines for Screening Pap Tests and Pelvic Exams

Medicare Guidelines for Screening Pap Tests and Pelvic Exams

Overview Important female preventive health care includes screening pap tests and pelvic exams. Medicare covers Pap smears, pelvic exams, STI and HPV screenings. A screening Pap test is the laboratory test used to detect early cervical cancer. A screening pelvic exam helps detect precancers, genital cancers, infections, STI’s, reproductive system abnormalities, and other genital/vaginal problems…

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…