by Lori | Apr 19, 2012 | Medicare payment basics
Evaluation and Management Services According to Medicare’s Documentation Guidelines for Evaluation and Management Services, a level-3 established patient office visit requires medical decision making of low complexity. Moderate-complexity decision making is required...
by Lori | Feb 16, 2012 | Medicare payment basics
Key point to remember As stated in the Centers for Medicare & Medicaid Services (CMS) Internet-only Manuals (IOM) 100-04, Chapter 12, Section 30.6.1: Medical necessity of a service is the overarching criterion for payment in addition to the individual requirements...
by Lori | Nov 6, 2011 | Medicare payment basics
E&M service with Emergency Emergency Department Services : Claims for emergency department E&M services must be accompanied by an appropriate diagnosis code reflecting the need for the level of E&M services rendered. Inappropriate upcoding is subject to...
by Lori | Nov 4, 2011 | Medicare payment basics
CPT 99357 with E&M Services CPT-4 Code 99357 To report prolonged inpatient E&M services, CPT-4 codes 99357 (each additional 30 minutes) must be billed in conjunction with code 99356. Billing Calculations CPT-4 codes 99356 and 99357 are subject to the least...
by Lori | Oct 26, 2011 | Medicare payment basics
CPT 99355 with E&M services CPT-4 Code 99355 To report additional prolonged outpatient E&M services, CPT-4 code 99355 (each additional 30 minutes) must be billed in conjunction with code 99354. Billing Calculations CPT-4 codes 99354 and 99355 are subject to...
