"CPT Code: 99233" Articles

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April 2nd, 2020

More Telehealth Changes Announced by CMS

By Wyn Staheli, Director of Research | Published April 2nd, 2020

On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). See this article for further information as well as references & links to CMS information

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August 13th, 2019

How to Properly Report Prolonged Evaluation and Management Services

By Aimee Wilcox | Published August 13th, 2019

Have you ever had a patient take more time with the provider than they were scheduled for? Do you understand which codes to report and the rules that govern them to allow for better reimbursement? Prolonged Service codes were created just for that reason but you must carefully follow the documentation ...

April 23rd, 2019

Let's Talk High Risk E/M Services

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published April 23rd, 2019

Have you ever assigned a high-complexity E/M code (e.g., 99205, 99215, 99223, 99233, 99245, etc.) and wondered if it would stand up to further scrutiny? Well, let’s take a closer look at the requirements for reporting high-level E/M services. Both the American Medical Association and Medicare-published E/M Guidelines agree that a ...

March 21st, 2019

The Impact of Medical Necessity on High Level E/M Services

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published March 21st, 2019

I was recently asked the question, "Does 99233 require documentation of a past medical, family, and/or social history (PFSH)?" The quick answer is, "it depends." Code 99233 has the following minimal component requirement: Subsequent inpatient E/M encounters can meet the code level requirement either by component scoring & medical necessity or time & medical necessity. ...

January 28th, 2019

Q/A Neonate Coding When Child is Transferred (2019/01/17)

By Codapedia | Published January 28th, 2019

Codapedia Forum - Questions & Answers Q/A: Neonatologist was at the birth of a very critical child, she billed 99468 and then it was decided to transfer the child to another facility, she also billed 99291 and 99292 x 3. Her time was denied, how should she have billed for the initial ...

March 26th, 2018

Documentation for Evaluation and Management (E/M) Services

By | Published March 26th, 2018

According to WPS, when billing or coding for E/M services you should follow a few guidelines. Documentation must support the level of service billed and the medical necessity for the level billed. Below are additional tips for services which commonly incur CERT error findings for insufficient documentation. Critical Care Visits Clear indication of patient ...

March 9th, 2018

The Comprehensive Error Rate Testing Program

By Frank Cohen, MBA, MPA | Published March 9th, 2018 - Last Review/Update April 12th, 2018

With nearly a million physicians in this country, how do auditing organizations determine whom to audit?

February 23rd, 2018

The Comprehensive Error Rate Testing Program

By Frank Cohen, MBA, MPA | Published February 23rd, 2018 - Last Review/Update February 26th, 2018

With nearly a million physicians in this country, how do auditing organizations determine whom to audit?

January 25th, 2018

Psychiatric Partial Hospitalization Programs

By Wyn Staheli, Director of Research | Published January 25th, 2018

Psychiatric Partial Hospitalization Programs (PHPs) are a more comprehensive level of care than Intensive Outpatient Programs (IOPs - click here to read more about IOPs). When the patient requires a minimum of 20 hours per week and hospitalization is not clinically indicated, a PHP can be the most effective type of ...

October 13th, 2017

So, How Do You Decide if a Service was Provided?

By David Glaser, JD | Published October 13th, 2017 - Last Review/Update January 31st, 2018

An earlier coding tip explained that the oft-repeated "if it isn't written, it wasn't done" is good risk management advice, but not a legal truism.....

September 12th, 2017

Auditing Prolonged Evaluation and Management Services

By Aimee Wilcox | Published September 12th, 2017 - Last Review/Update September 18th, 2017

At times, there are patients who require prolonged face-to-face time with the provider to discuss or be counseled about their condition, plan of care, risks, complications, alternative therapies, or other medical issues. When E/M services go wild, taking significantly longer than the typical time associated with it, that direct face-to-face ...

August 16th, 2017

If It’s Not a Consultation, What Is It?

By Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC | Published August 16th, 2017

You thought you had a consultation supported in your documentation, and now you find out that you cannot bill the consultation codes (99241-99245, 99251- 99255). So, what are the top reasons for a consultation not to be supported? If the payer does not support these codes If the documentation does not support ...

July 7th, 2017

Telemedicine: The Next Frontier in Care Delivery

By Valora Gurganious, MBA, CHBA | Published July 7th, 2017 - Last Review/Update January 25th, 2018

Technology is ubiquitous in modern society, and just when we thought that computers could not replace the "human touch" of a healthcare provider, technology is making specialized care accessible to patients anywhere there is an internet connection.

July 29th, 2016

Subsequent hospital visits

By Codapedia | Published July 29th, 2016

Hospital services are all defined by CPT® as per day codes, that is, all of the care provided to a hospitalized patient during the calendar day. If a physician (or that physician's covering partner of the same specialty) sees the patient a second time during the calendar day, a second...

February 17th, 2016

TeleMedicine Terms and Definitions and who can bill - Using Modifiers

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 17th, 2016 - Last Review/Update August 4th, 2017

Medical practitioners who can bill for a covered Telehealth service vary by state law, but they may include: physician, nurse practitioner, physician assistant, nurse midwife, clinical nurse specialist, clinical psychologist, clinical social worker, and registered dietician or nutrition professional Distant or Hub site: Site at which the physician or other licensed practitioner delivering the service is located at the time the ...

February 12th, 2016

Patient Status: Hospital Inpatient vs. Observation

By Jeanette Anderson, CPC, CPMA | Published February 12th, 2016 - Last Review/Update August 16th, 2017

As an auditor, we must ensure that the documentation supports the selected use of codes for reimbursement. When auditing hospital encounters, the patient status serves as the basis for the code selection and therefore must be clearly documented. This ensures that the hospital is able to collect appropriate reimbursement. During an ...

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"CPT Code: 99233" Articles

More Telehealth Changes Announced by CMS

How to Properly Report Prolonged Evaluation and Management Services

Let's Talk High Risk E/M Services

The Impact of Medical Necessity on High Level E/M Services

Q/A Neonate Coding When Child is Transferred (2019/01/17)

Documentation for Evaluation and Management (E/M) Services

The Comprehensive Error Rate Testing Program

The Comprehensive Error Rate Testing Program

Psychiatric Partial Hospitalization Programs

So, How Do You Decide if a Service was Provided?

Auditing Prolonged Evaluation and Management Services

If It’s Not a Consultation, What Is It?

Telemedicine: The Next Frontier in Care Delivery

Subsequent hospital visits

TeleMedicine Terms and Definitions and who can bill - Using Modifiers

Patient Status: Hospital Inpatient vs. Observation

article requests

contact

article topics