decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 1 (January)
New coding guidance – It could be you: CMS officials announce individual approach to X modifiers
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Article Overview
This article covers Medicare and CPT coding updates discussed by CMS and AMA representatives at the CPT and RBRVS 2015 Symposium. It is relevant to coders, compliance staff, and providers who need to stay current on modifier policy, drug screen coding developments, and evaluation and management documentation changes for 2015. The discussion includes general guidance themes, carrier outreach, cross-walk efforts between code sets, and revisions to social history data points.
Why This Topic Matters
The topic affects how practices respond to payer communication, keep coding aligned with current Medicare and CPT guidance, and prepare for documentation changes in the 2015 E/M guidelines.
Article Sections
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Docs will be singled out to use X modifiers
Discusses carrier communication related to modifier policy and broader questions about use of the X modifier family in place of older billing approaches.
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Watch for more drug screen guidance
Covers anticipated clarification for drug screen coding and the relationship between CPT and HCPCS code sets.
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E/M guideline changes
Summarizes updates to social history documentation elements in the 2015 CPT guidance and the reasons cited for those changes.
What You Will Learn
- The general direction of CMS and carrier communication on modifier policy
- How the article frames evolving guidance for drug screen coding
- What changed in the 2015 CPT social history documentation categories
- Which organizations and symposium discussions are associated with the updates
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physician practices
- Carrier and payer policy watchers
Modifiers Discussed
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