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Guidelines and Manuals

Below is a list of categories with applicable links and resources for your convenience.

CPT Coding

AMA's E&M Guidelines

Evaluation and Management (E/M) Services Guidelines

AMA's CPT Section Guidelines

Search AMA's CPT Guidelines by Section

E&M Code Guidelines & Instructions

E&M Code Guidelines and Evaluation & Management Code Instructions

1995 E&M Documentation Guidelines

1995 Documentation Guidelines for Evaluation & Management Services

1997 E&M Documentation Guidelines

1997 Documentation Guidelines for Evaluation and Management Services

Diagnostic Coding

ICD-10-CM Guidelines

The Official ICD-10-CM Guidelines for Coding and Reporting

ICD-10-CM Quick Reference

MLN's ICD-10-CM Classification Enhancements

ICD-9-CM Guidelines

The Official ICD-9-CM Guidelines for Coding and Reporting

Hospital/Facility Coding

ICD-10-PCS Official Guidelines

The Official ICD-10-PCS Guidelines for Coding and Reporting

ICD-10-PCS Reference Manual and Files

ICD-10-PCS Reference Manual

ICD-9 Vol. 3 Coding Information

ICD-9 vol 3 Procedure Code Information

APC Coding

APC Codes (Ambulatory Payment Classifications)


InstaGuide to the CMS 1500

InstaGuide to the CMS 1500 Health Insurance Claim Form

Medicare CMS 1500 Instructions

Medicare CMS1500 02/12 Claim Form Instructions

Revised CMS-1500 Form Overview

The Revised CMS-1500 Form … at a Glance

Dental ADA Claim Form

ADA Claim Form 2006 - Paper

ADA Claim Form Instructions

ADA Claim Form 2006 - Electronic Instructions


Provider Compliance Newsletter

Medicare Quarterly Provider Compliance Newsletter


Medicare Factsheets

PUB 100: Internet Only Manuals (IOMs)

CMS: Internet Only Manuals

PUB 100-01

General Information Manual

PUB 100-02

Benefit Policy Manual

PUB 100-03

National Coverage Determinations

PUB 100-04

Claims Processing Manual

PUB 100-05

Secondary Payer Manual


Merit-based Incentive Payment System (MIPS)

MIPS Manual

Medicare Quality Reporting Incentive Programs Manual


Clinical Laboratory Improvement Amendments (CLIA)

E&M Guides & Manuals

Medicare Evaluation & Management (E&M) Guides and Manuals


Search LCDs, Articles, and NDCs by Medicare Contractors


Medicare Forms

NCCI Edits Policy Manual

NCCI Policy Manual Archive

Paper-Based Manuals

Medicare Paper-Based Manuals


Medicare FAQs

Hospital Outpatient Regulations and Notices

Hospital Outpatient Regulations and Notices


National Coverage Determinations

CMS-1500 Claim Form Tutorial

CMS-1500 Claim Form Tutorial


Federal Register

Federal Register Document Search

OIG Physician Compliance

OIG Compliance Program for Individual and Small Group Physician Practices


Over 29 million citations for biomedical literature from MEDLINE, life science journals, and online books

Guidelines and Manuals Articles

Click the article title to view a summary and link to the full article.

The New ICD-10-CM Code Updates Are Here — Are You Ready?


Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases. Chapter 2: ...

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Let's Talk High Risk E/M Services


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 ...

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What is Medical Necessity and How Does Documentation Support It?


We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

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


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. ...

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Understanding NCCI Edits


Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for ...

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Proposed Rule: Expanded Telemedicine Benefits for Medicare Advantage Beneficiaries


Telemedicine continues its rise, with new technologies allowing for better communication and access to more aspects of healthcare than ever before. Each year Medicare has made strides, albeit small strides, in their telemedicine coverage while commercial payers continue to make great strides, constantly improving and expanding telemedicine service offerings to ...

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Truncated ICD-10-CM Official Guidelines for Coding and Reporting


Adherence to ICD-10-CM official guideline's are required under HIPAA and adopted for all healthcare settings. We have made it easy to access guidelines and made them available on the code information page, either on the page you are viewing or view more information by selecting the ICD-10-CM Chapter Section/Guidelines and ...

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WHO Said ICD-11 is Coming Soon


Sooner or later ICD-11 will be released, and it sounds like it will be sooner than later. WHO released the news on June 18, 2018. The World Health Organization stated “ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come ...

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Reimbursement Guides
2020 Edition

Find-A-Code's 2020 specialty specific Reimbursement Guides give you the coding, billing, and documentation support you need to get paid properly and keep it.

  • Medicare
  • Procedure & Supply codes
  • Documentation
  • Compliance
  • HCC information
  • ICD-10-CM codes

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