(2022) CPT 98960 – 98962 (Patient Self-Management Education & Training)

(2022) CPT 98960 – 98962 (Patient Self-Management Education & Training)

Services prescribed by a physician and provided by a qualified nonphysician healthcare professional designed to teach patients how to effectively self-manage illness(es) or disease(s) including asthma and diabetes may be coded as follows when a standardized curriculum is used. The CPT codes to report Patient Self-Management Education and Training are as follows. List With CPT…

CARC Codes And RARC Codes (2022)

CARC Codes And RARC Codes (2022)

CARC and RARC Codes The following information is for RARC codes & CARC codes meaning for medical billing. What are CARC Codes? CARC Codes ar ‘Claim adjustment reason codes’ (abbreviation: CARC). CARC codes communicate an adjustment, meaning that they must communicate why a claim or service line was paid differently than it was billed. If…

Medically Unlikely Edits (MUEs)

Medically Unlikely Edits (MUEs)

CMS developed MUEs to reduce the paid claims error rate for Medicare claims. Just like the NCCI edits, the MUEs are automated prepayment edits that help prevent inappropriate payments. The Affiliated Contractors (ACs) / Medicare Administrative Contractors (MACs) systems analyze the procedures on the submitted claim to determine if they comply with the MUE policy. What are MUEs? An…

Urgent Care Centers – CPT Coding Guidelines (2022)

Urgent Care Centers – CPT Coding Guidelines (2022)

Urgent Care Centers are the Facilities that delivers Outpatient Medical Care usually for the conditions that does not require Hospital admission. Urgent care centers are primarily used to treat patients with acute and chronic injury or illness (that are not life-threatening conditions for the patient) that requires immediate attention. Urgent care Facilities are designed to…

What’s the Social Security Number Removal Initiative (SSNRI)?

What’s the Social Security Number Removal Initiative (SSNRI)?

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. Refer CMS…

Contractors & Consultation Codes When Medicare Is Secondary Payer

Contractors & Consultation Codes When Medicare Is Secondary Payer

Medicare will also no longer recognize the CPT consultation codes for purposes of determining Medicare secondary payments (MSP). In MSP cases, providers must bill an appropriate E/M code for the E/M services previously reported and paid using the CPT consultation codes. If the primary payer for the service continues to recognize CPT consultation codes for…

What Is The CPT Code For MMSE (Mini Mental Status Exam)?

What Is The CPT Code For MMSE (Mini Mental Status Exam)?

The 1997 version of Medicare’s Documentation Guidelines for Evaluation and Management Services indicates that “brief assessment of mental status including: orientation to time, place and person; recent and remote memory; mood and affect (e.g., depression, anxiety, agitation)” as one of the exam elements for examination. The physician administration, interpretation and written report associated with the…

What is eRX Limiting Charge?

What is eRX Limiting Charge?

The Medicare Fee Schedule for the year 2013 will have an additional column ‘eRX Limiting Charge’ that denotes “Limiting charge reduced based on status as an unsuccessful e-prescriber per the Electronic Prescribing (eRx) Incentive Program.” Beginning on January 1, 2012, EPs who are not successful electronic prescribers are subject to a negative payment adjustment. Section…