Pub Date : 2022-09-01DOI: 10.1542/pcco_book221_document005
The American Medical Association Current Procedural Terminology (CPT) code manuals include not only codes and guidelines but also appendixes that provide additional coding guidance. Two new appendixes, S and T, were finalized after publication of the 2022 version of CPT. This article provides a brief description of each appendix and information on where the appendix can be accessed.
{"title":"Updates: Current Procedural Terminology® Appendixes","authors":"","doi":"10.1542/pcco_book221_document005","DOIUrl":"https://doi.org/10.1542/pcco_book221_document005","url":null,"abstract":"The American Medical Association Current Procedural Terminology (CPT) code manuals include not only codes and guidelines but also appendixes that provide additional coding guidance. Two new appendixes, S and T, were finalized after publication of the 2022 version of CPT. This article provides a brief description of each appendix and information on where the appendix can be accessed.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129398204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1542/pcco_book221_document001
This article addresses Changes to evaluation and management (E/M) code categories Code categories that will be selected based on either the level of medical decision-making (MDM) or on the physician or other qualified health care professional’s (QHP’s) total time on the date of the encounter, with 1 exception Notable differences in the descriptions of total time for codes revised in 2023
{"title":"Prepare for 2023: Evaluation and Management Code and Guideline Changes Announced","authors":"","doi":"10.1542/pcco_book221_document001","DOIUrl":"https://doi.org/10.1542/pcco_book221_document001","url":null,"abstract":"This article addresses\u0000 Changes to evaluation and management (E/M) code categories Code categories that will be selected based on either the level of medical decision-making (MDM) or on the physician or other qualified health care professional’s (QHP’s) total time on the date of the encounter, with 1 exception Notable differences in the descriptions of total time for codes revised in 2023","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114674243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1542/pcco_book221_document003
Did you know that vaccine counseling that does not result in immunization administration on the date of counseling may be separately reportable and eligible for separate payment through Medicaid and the Children’s Health Insurance Program (CHIP)? This is especially true for counseling for immunization against COVID-19, for which states can receive additional funding from the Centers for Medicare & Medicaid Services (CMS)..
{"title":"Did You Know? Medicaid and Children’s Health Insurance Program Early and Periodic Screening, Diagnostic, and Treatment Services and Vaccine Counseling","authors":"","doi":"10.1542/pcco_book221_document003","DOIUrl":"https://doi.org/10.1542/pcco_book221_document003","url":null,"abstract":"Did you know that vaccine counseling that does not result in immunization administration on the date of counseling may be separately reportable and eligible for separate payment through Medicaid and the Children’s Health Insurance Program (CHIP)? This is especially true for counseling for immunization against COVID-19, for which states can receive additional funding from the Centers for Medicare & Medicaid Services (CMS)..","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130906740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-01DOI: 10.1542/pcco_book221_document006
This article will review appropriate reporting of code 99211, including the following: • Code description and values • Guidelines for reporting 99211 • Application of incident-to policy • Services that are reported with 99211 • Services that are not reported with 99211
{"title":"Code 99211: Reporting Office Evaluation and Management Services by Clinical Staff (Online Exclusive)","authors":"","doi":"10.1542/pcco_book221_document006","DOIUrl":"https://doi.org/10.1542/pcco_book221_document006","url":null,"abstract":"This article will review appropriate reporting of code 99211, including the following: • Code description and values • Guidelines for reporting 99211 • Application of incident-to policy • Services that are reported with 99211 • Services that are not reported with 99211","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125277290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1542/pcco_book220_document005
The American Medical Association (AMA) has published the Current Procedural Terminology® 2023 evaluation and management (E/M) guidelines on their website. This guideline publication gives physicians, coders, and educators an early opportunity to prepare for compliance with the revised guidelines beginning with services provided on and after January 1, 2023. This brief article reviews related topics that will be covered in upcoming editions of the AAP Pediatric Coding Newsletter.
{"title":"2023 Evaluation and Management Code Changes: Publication Details","authors":"","doi":"10.1542/pcco_book220_document005","DOIUrl":"https://doi.org/10.1542/pcco_book220_document005","url":null,"abstract":"The American Medical Association (AMA) has published the Current Procedural Terminology® 2023 evaluation and management (E/M) guidelines on their website. This guideline publication gives physicians, coders, and educators an early opportunity to prepare for compliance with the revised guidelines beginning with services provided on and after January 1, 2023. This brief article reviews related topics that will be covered in upcoming editions of the AAP Pediatric Coding Newsletter.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133045398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1542/pcco_book220_document002
This month’s Coding Hotline examines the appropriate way to report an adolescent health supervision that addresses unhealthy eating habits and inadequate sleep, extending the encounter.
{"title":"Coding Hotline","authors":"","doi":"10.1542/pcco_book220_document002","DOIUrl":"https://doi.org/10.1542/pcco_book220_document002","url":null,"abstract":"This month’s Coding Hotline examines the appropriate way to report an adolescent health supervision that addresses unhealthy eating habits and inadequate sleep, extending the encounter.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121235743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1542/pcco_book220_document001
This article demonstrates how to select a level of medical decision-making (MDM) based on the highest 2 of 3 elements of MDM along with tips for quickly selecting accurate codes. It specifically addresses Determining which code category to report (new patient [99202–99205] or established patient [99212–99215])Steps to selecting the level of MDMComparing the level of MDM to the total time spent on the date of an encounter
{"title":"Preparing for 2023: Selecting the Level of Service Based on Medical Decision-making","authors":"","doi":"10.1542/pcco_book220_document001","DOIUrl":"https://doi.org/10.1542/pcco_book220_document001","url":null,"abstract":"This article demonstrates how to select a level of medical decision-making (MDM) based on the highest 2 of 3 elements of MDM along with tips for quickly selecting accurate codes. It specifically addresses Determining which code category to report (new patient [99202–99205] or established patient [99212–99215])Steps to selecting the level of MDMComparing the level of MDM to the total time spent on the date of an encounter","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134610245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1542/pcco_book220_document003
This article reviews the Current Procedural Terminology (CPT®) codes and guidelines for selecting appropriate codes for evaluation and management (E/M) services provided to hospital patients in inpatient or observation stays. The following topics are reviewed: Services that are designated as initial or subsequent encounters General differences in requirements of initial and subsequent encounter codes Guidelines for code selection by the admitting or attending physician Guidelines for code selection by physicians other than the admitting or attending physician
{"title":"Coding for Initial and Subsequent Hospital Encounters","authors":"","doi":"10.1542/pcco_book220_document003","DOIUrl":"https://doi.org/10.1542/pcco_book220_document003","url":null,"abstract":"This article reviews the Current Procedural Terminology (CPT®) codes and guidelines for selecting appropriate codes for evaluation and management (E/M) services provided to hospital patients in inpatient or observation stays. The following topics are reviewed:\u0000 Services that are designated as initial or subsequent encounters General differences in requirements of initial and subsequent encounter codes Guidelines for code selection by the admitting or attending physician Guidelines for code selection by physicians other than the admitting or attending physician","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121569634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1542/pcco_book220_document006
This article discusses reporting requirements for evaluation and management (E/M) services in hospital inpatient and observation settings when a payer’s policy does not allow payment for services reported with consultation codes. Key topics include Use of the AI modifier by the admitting or attending physician Codes reported by a consulting physician when a payer doesn’t accept consultation codes
{"title":"Reporting Hospital Services When Consultation Codes Are Excluded From Payment (Online Exclusive)","authors":"","doi":"10.1542/pcco_book220_document006","DOIUrl":"https://doi.org/10.1542/pcco_book220_document006","url":null,"abstract":"This article discusses reporting requirements for evaluation and management (E/M) services in hospital inpatient and observation settings when a payer’s policy does not allow payment for services reported with consultation codes. Key topics include\u0000 Use of the AI modifier by the admitting or attending physician Codes reported by a consulting physician when a payer doesn’t accept consultation codes","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130864781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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