Preventive Medicine Versus E&M Codes: The Same-Day Coding Dilemma

Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient…

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Know the Ropes for Problem Discovered During Well-Visit

Question: We have a Medicaid patient that came in for a ten year-old physical and was found to be sick, so we would like to append modifier 25 to report the well turned-sick visit. Is that accurate?- Virginia Subscriber Answer: Yes. In this situation, ...

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CMS Slashes Conversion Factor for 2011, Establishes Preventive Visit Codes

Get ready for another year of nail-biting to find out if your Medicare payments will be slashed. “The calendar year 2011 Physician Fee Schedule conversion factor is $25.5217,” notes the 2011 Medicare Physician Fee Schedule Final Rule, printed in th...

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Face Off Against Common Sports Physical Coding Challenges

Hint: Gathering upfront pay and watching E/Ms make a difference.

Children need physicals to participate in their favorite sports year round, but the demand can grow with warm weather approaching. Ideally, the need for sports physicals should provide the opportunity...

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Ensure Multi-Vaccine Payment With This Coding Advice

You may need to append modifier 25, depending on payer policies.

Question: Our physician billed 90634, 90710, and 90606 for vaccines given to a 5-year-old patient. The insurance company denied payment and said they required a modifier. What should we

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How Do I Code Genetic Counseling By A Physician

Limit 96040 to Trained Counselor Question: May we report 96040 if our physician is performing genetic counseling? Answer: You should report 96040 (Medical genetics and genetic counseling services, each 30 minutes face-toface with patient/family) only for a trained genetic counselor’s services. (Currently, the American Board of Genetic Counselors [ABMG] certifies genetic counselors in the US and Canada.) [...] Related articles:

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