Check in with a cardiology coding expert for “real world” solutions to your E/M coding problems that have cropped up in the three months since consultations have been gone.

Medicare eliminated consultations and now your cardiology practice must figure out how to use the replacement E/M codes. In the office setting, for example, visits that would have been consults prior to now must be coded as either new patient or established patient visits.

But CPT® and CMS disagree on who may bill a new patient. Find out which organization is correct as well as the latest Medicare guidance on this issue from cardiology coding expert Linda Gates-Striby. Cardiology coders also are re-thinking many other longstanding rules, such as whether referrals still need to be documented, what happens when a patient’s primary physician of record changes during the course of a hospital stay, and what happens at the carriers when they receive eight initial hospital care claims, but none with an “AI” modifier.

Get a refresher on the rules for coding these E/M services from coding expert Linda Gates Striby so you don’t inadvertently accrue denials

Additionally, government contracted auditors are looming, rifling through your claims to look for under-documented services – easy pickings for RACs, ZPICs and carrier recoup requests.

  • You’ll learn the ropes of shared/split visits, and how these services may expand this year. For example, who can do the four history components- what services an NPP can provide, and what Medicare rules state that the provider must do.
  • Find out how your peers are dealing with Medicare secondary payer situations, including whether it is ever practical to recode the claims with consult codes and what happens if a consult claim gets denied by your carrier (e.g. on an MSP claim) and what, if anything, you can do about it.
  • Solutions to common cardiology E/M problems, such as whether you typically can report a visit code with in-person device interrogation or programming analysis.
  • How to handle typical scenarios when the patient returns to review test results – when this is a billable visit.

You’ll also learn what it will take to report 99221 for your initial hospital visits, plus when you can code a service based on time, and what must be documented in order to do this.

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