decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 1 (January)
Billing an E/M with new anticoagulant codes
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Article Overview
This article explains how billing guidance applies when a practice provides both evaluation and management services and anticoagulant monitoring, and when diagnostic or procedure codes require professional-versus-technical component reporting. It is aimed at coders, billers, and specialty practices such as pediatric cardiology that need to understand broad CPT and Medicare fee schedule concepts discussed in the context of office, hospital, and imaging services.
Why This Topic Matters
The article helps practices determine whether common cardiology and monitoring services are billed separately or together and how modifier use can vary by ownership of equipment and service setting. It is relevant for avoiding inappropriate global reporting and for understanding how fee schedule structure affects claims.
What You Will Learn
- How the article frames billing of evaluation and management services alongside laboratory monitoring services.
- How professional and technical component concepts are discussed for cardiac and imaging procedures.
- How Medicare fee schedule information is referenced as a way to identify split-fee reporting.
- How service setting and equipment ownership are presented as factors in modifier use.
Who Should Read This
- Medical coders
- Medical billers
- Pediatric cardiology practices
- Cardiology practices
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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