Month: May 2021

Telehealth Coding Using Audio Only
Post

Telehealth Coding Using Audio Only

May 27, 2021 Question: My doctors are providing telehealth office visits using audio only. They have told me it is okay to use E/M codes 99202-99215 for telephone visits. I was reading the temporary guidelines for Telehealth during the PHE and cannot verify these are the right codes. Can you help? Answer: When the telehealth...

Shared Services in the Hospital
Post

Shared Services in the Hospital

May 27, 2021 Question: Our practice understands how to report shared services in the hospital when the physician assistant and physician both see the patient on the same day. My question, and I have not found anyone who is able to answer is, how do we bill when a hospital-employed physician assistant and our physician...

Does Type of Scope – Rigid or Flexible – Matter for Coding?
Post

Does Type of Scope – Rigid or Flexible – Matter for Coding?

My 27, 2021 Question: Does 31231 (nasal endoscopy) have to be done with a rigid scope? Answer: The CPT descriptor for 31231 is: Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure). Notice it does not specify whether the scope must be rigid or flexible. That said, CPT makes it clear that the anatomic structures examined...

New 2021 E/M Coding Guidelines
Post

New 2021 E/M Coding Guidelines

May 27, 2021 Question: In the new guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time with the patient? Answer: Good question!  Only the time of teaching physician would “count” in the scenario you describe.  The new guidelines say that the time of...

Two-Level Kyphoplasty
Post

Two-Level Kyphoplasty

May 27, 2021 Question: When doing a T12 & L3 kyphoplasty, are the correct codes 22513 (thoracic) and 22514 (lumbar)? Answer: The correct codes are 22513 (thoracic) and +22515 (additional level) for your example. It is not accurate to report two stand-alone codes (22513 and 22514) for procedures performed at the same operative session. *This...

Post

New Procedures Added to Medicare’s Prior Authorization (PA) List Effective 7/1/21

May 26, 2021 Since 7/1/20, when CMS initiated a requirement for specific procedures to be prior authorized, we have sent out two KZAlerts about the PA process Alert 1 Alert 2 CMS says the PA policies are to ensure Medicare patients receive “necessary care” and “reduce unnecessary increases in the volume” of covered outpatient services....

Coding for FAST Exams
Post

Coding for FAST Exams

May 27, 2021 Question: I was told I cannot bill for FAST exams done in the ED for a trauma patient, if permanent recordings of the images are not retained. Is that correct? Answer: Yes. All diagnostic ultrasounds require 1) a separate interruption of the structures visualized and the findings in each and 2) a...

  • 1
  • 2
Sign up for KZAlertsSign up for KZAlerts

Coding Coaches