Medical Billing and Coding

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Find comprehensive tools and resources to help you code accurately and optimize documentation and payment.

Coding for Evaluation and Management Services

The evaluation and management (E/M) patient visit is the core of most family physician practices. Family physicians and other qualified heath care providers can maximize payment and reduce stress associated with audits by understanding how to properly document and code E/M patient visits. Learn more about E/M coding including:

  • Components of E/M
  • 1995 vs. 1997 guidelines
  • Tips and tricks video

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Coding Basics

Accurate and appropriate coding is vital, not only for payment purposes, but for documentation and compliance. Learn the basics of:

  • HCPCS level I (CPT codes), level II codes not included in CPT
  • ICD-10-CM

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Medicare Wellness & Care Coordination

Provide Medicare wellness and care coordination services to optimize fee-for-service revenue, improve quality, and decrease total cost of care. Services include:

Hierarchical Condition Category

Hierarchical condition category (HCC) coding is a risk-adjusted model originally designed to estimate future health care costs for patients. HCC coding helps communicate patient complexity to ensure your payments match the risk of the patients you treat.

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Coding for Group Visits

Many physicians are interested in providing group medical visits, but as with many other services, coding for group visits requires that billing and coding staff do preliminary work with payers to identify desired coding applications. Learn more about coding for group visits.  

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Coding for Newborn Care Services

In the first days of life a dedicated set of evaluation and management service codes are provided for newborn care, including:

  • Newborn care in the office
  • Circumcision
  • Caring for sick newborns
  • Newborn critical care
  • Critical care during transport
  • Inpatient neonatal critical care

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Coding for Vaccine Administration

Learn about coding for vaccine administration, including:

  • Vaccines administered at well-child visits
  • ICD-10 for combination vaccines
  • E/M services provided on the same date as vaccine administration
  • Adding national drug codes (NDC) to claims
  • Reporting administration per component
  • Administration coding example  

More About Coding for Vaccine Administration»

Non-covered Services

There are two main categories of services for which physicians may not get paid by Medicare:

  • Services not deemed medically reasonable or necessary
  • Non-covered services

Learn About Non-covered Services»

Coding Reference Cards Bundle

The AAFP Coding Reference Cards Bundle support you and your practice team in appropriately coding and documenting childhood immunizations, dermatology services, and basic obstetrics, gynecologic, and neonate services.