Category: CC-Neurosurgery

Documenting Time and Medical Decision Making in the 2021 E/M Code Revisions
Post

Documenting Time and Medical Decision Making in the 2021 E/M Code Revisions

April 1, 2021 Question: Under the new E/M coding revisions for office visits, should we document time AND medical decision making for every visit? Answer: According to advice from the AMA (3/24/21 webinar), you should only document one or the other to prevent potential audit confusion and risk. Document time if billing by time OR...

In-House MRI and “Counting” Data for New E/M Guidelines
Post

In-House MRI and “Counting” Data for New E/M Guidelines

February 18, 2021 Question: We have an MRI in house which has made me confused about how to count the data for the neurosurgeon’s E/M code.  Please help. Answer: Good question and let’s simplify things. The AMA specifically states there should be “no incentive”, related to E/M coding, to the physician for ordering tests. So...

New 2021 E/M Coding Guidelines
Post

New 2021 E/M Coding Guidelines

February 4, 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...

Removal of CP Angle Meningioma
Post

Removal of CP Angle Meningioma

December 3, 2020 Question: What’s the best way to code a retrosigmoid approach and removal of a meningioma at the cerebellopontine angle? Should I use 61519 or 61520? Answer: CPT 61520 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor) is more accurate since it better describes the location of the...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches