Outpatient Facility Coding Alert - 2007 Issue 37
COVERAGE: Medicare Is Pro High-Tech -- Except When It Comes To E/M Visits
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Article Overview
This article reviews CMS and Medicare policy changes affecting certain CPT evaluation and management services for 2008, with emphasis on coverage limitations, bundled-status decisions, and the practical impact on physician billing. It is relevant to coders, compliance staff, and physicians who need to understand which categories of E/M-related services are addressed in the physician fee schedule and how Medicare’s approach may differ from the code set itself.
Why This Topic Matters
Medicare payment policy can determine whether services in CPT are payable, bundled, or not covered, which directly affects billing workflows, compliance, and revenue capture. This article helps readers identify which service categories are discussed and why these policy choices matter to practices offering communication-based, conference-based, and management services.
Article Sections
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Anticoagulation management is still bundled for 2008
This section discusses Medicare coverage and bundling policy for selected CPT services in the 2008 physician fee schedule. It also addresses related CMS treatment of communication-based E/M services and other management-related services.
What You Will Learn
- Which categories of CPT evaluation and management services are addressed in the 2008 Medicare physician fee schedule
- How CMS treatment of communication-based services differs from general CPT availability
- What broad types of management and conference-related services are discussed in the article
- How coverage and bundling decisions can affect physician billing and compliance
Who Should Read This
- Medical coders
- Compliance officers
- Physicians
- Practice managers
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
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