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99213

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Fighting for a Fee Schedule That Works for You, Your Patients

The AAFP is working on a detailed response to the proposed 2019 Medicare physician fee schedule that steers CMS toward fixes that will help family physicians give patients the comprehensive, continuous care they expect.

https://www.aafp.org/news/opinion/20180821presmsg-mpfs.html

Coding for Evaluation and Management Services

Maximize payment and reduce stress by understanding how to properly document and code for evaluation and management (E/M) services.

https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management.html

Sep 2005

...Coding "Routine" Office Visits: 99213 or 99214? Peter R. Jensen Departments From the Editor New and Improved for You Leigh Ann Backer Editorial Ten Hard Questions About the Future of the Specialty Douglas Iliff Coding & Documentation • Hypertension...

Family Practice Management

https://www.aafp.org/fpm/2005/0900

Coding E/M visits by medical decision making -- FPM

Starting Jan. 1, physicians will be able to code evaluation and management visits based solely on medical decision making, which is made up of three elements.

Family Practice Management : Quick Tips : FPM Home

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/medical_decision_making.html

Early Thoughts on the 2019 Fee Schedule

AAFP staff members are reviewing the 2019 Medicare physician fee schedule. In the latest In the Trenches post, Senior Vice President for Advocacy, Practice Advancement and Policy Shawn Martin shares some initial reactions based on the Academy's early evaluation of the proposal.

AAFP News : In the Trenches : Blogs

https://www.aafp.org/news/blogs/inthetrenches/entry/20180731itt_feeschedule.html

Telehealth FAQs

Telehealth and telemedicine can be confusing to navigate, especially during the COVID-19 pandemic. The AAFP has gathered the top questions to get you the exact information you need to bill and code telehealth correctly.

https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-telehealth/telehealth-faqs.html

What's your coding profile? -- FPM

Comparing your E/M coding distribution with national benchmarks will help you identify aberrant coding patterns and make adjustments before they raise a red flag with payers or cost your practice money.

Family Practice Management : Getting Paid : FPM Home

https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/whats_your_coding_profile.html

Think 99214 if you see these problems or procedures -- FPM

The risk component of medical decision making is more subjective and can be difficult to identify, so here’s what to look for.

Family Practice Management : Quick Tips : FPM Home

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/99214_presenting_problems.html

Four tips to help you spend less time charting -- FPM

To get through your routine documentation more efficiently and reduce work after clinic, try these tips.

Family Practice Management : Quick Tips : FPM Home

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/spend_less_time_on_charting.html

Coding office visits the easy way - based on time -- FPM

An E/M office visit may be coded based solely on face-to-face time when more than half is devoted to counseling or coordination of care.

Family Practice Management : Quick Tips : FPM Home

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/coding_office_visits_the_easy_way.html

Potential pitfall in Medicare billing: psychotherapy in conjunction with an evaluation ...

Potential pitfall in Medicare billing: psychotherapy in conjunction with an evaluation and management service

Family Practice Management : Getting Paid : FPM Home

https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/potential_pitfall_in_medicare_billing.html

E-Prescribing codes for 2012 -- FPM

E-Prescribing codes for 2012

Family Practice Management : Getting Paid : FPM Home

https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/e_prescribing_codes_for_2012.html

Coding From the Bottom Up -- FPM

Dec 1, 2008 - Start from the presenting problem to get to the right code faster.

Family Practice Management : Articles

https://www.aafp.org/fpm/2008/1100/p22.html

Level-II vs. Level-III Visits: Cracking the Codes -- FPM

Jan 1, 2007 - Once you learn the rules, choosing the right code is easier than you think.

Family Practice Management : Articles

https://www.aafp.org/fpm/2007/0100/p21.html

Is Your Medicare Payer Playing by the Rules? -- FPM

Aug 1, 2010 - Don't let varying interpretations of the evaluation and management guidelines keep you from getting paid.

Family Practice Management : Articles

https://www.aafp.org/fpm/2010/0700/p27.html

Why the Medicare Fee Schedule and RVUs Matter to Employed Family Physicians -- FPM

Jun 1, 2010 - When Medicare payments are cut, everybody loses, not just self-employed physicians.

Family Practice Management : Opinion

https://www.aafp.org/fpm/2010/0500/p7.html

Coding & Documentation - Sep-Oct 2009 -- FPM

Oct 1, 2009 - ...observation care services on day one, 99213 for observation care on day two and 99217 for observation care discharge services on day three. The hospital listed the patient as an outpatient all three days. Is there a better code than 99213 to use for day two? Also, should 99219 be...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2009/0900/p30.html

Ten Steps to a Patient-Centered Medical Home -- FPM

Dec 1, 2009 - Start with steps that increase practice revenue. Then you'll be better able to afford the steps that just make practice better and more satisfying.

Family Practice Management : Articles

https://www.aafp.org/fpm/2009/1100/p18.html

A Quick-Reference Card for Identifying Level-4 Visits -- FPM

Aug 1, 1999 - The author's tool will help you keep in mind what qualifies a visit for a 99214 or a 99204.

Family Practice Management : Articles

https://www.aafp.org/fpm/1999/0700/p32.html

Practice Pearls - Sep-Oct 2009 -- FPM

Oct 1, 2009 - ...The typical office visit for a family physician is represented by CPT code 99213. The work RVUs for that code in 2009 are 0.92. Based on this number, at 20 visits per day a family physician might be expected to generate 18.4 work RVUs per day, on average. Kent J. Moore AAFP Leawood,...

Family Practice Management : Practice Pearls

https://www.aafp.org/fpm/2009/0900/p31.html

Chart Audit: Is Your Practice Billing What It Should? -- FPM

Apr 1, 2009 - A simple review may save your practice loads of money.

Family Practice Management : Articles

https://www.aafp.org/fpm/2009/0300/p15.html

Coding & Documentation - Nov 2008 -- FPM

Dec 1, 2008 - ...We had a patient come in for a routine diabetic checkup, which we billed using CPT code 99213 and ICD-9 code 250.02. A few hours later, this patient came in with a migraine and hypertension issues. Could we have reported code 99058 for the second visit? A Code 99058 is to be...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2008/1100/p37.html

Charting Then and Now -- FPM

Feb 1, 2009 - Chart notes used to be primarily for doctors, but oh how times have changed.

Family Practice Management : The Last Word

https://www.aafp.org/fpm/2009/0100/p40.html

Coding & Documentation - Jan-Feb 2009 -- FPM

Feb 1, 2009 - ...a patient comes in for a sinus infection and I administer an injection of Celestone for the sinus infection, can 90772 be billed along with 99213? What if the sinus infection was the primary focus of the visit but I administer a B12 shot for anemia? A You can report both codes as...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2009/0100/p30.html

Are Your Payers' Fee Schedules Fair? -- FPM

Apr 1, 2007 - If they use multiple conversion factors when determining what they'll pay, you may be at an even greater disadvantage than you realized.

Family Practice Management : Opinion

https://www.aafp.org/fpm/2007/0400/p13.html

A Multiple-Service Rule for E/M Services -- FPM

Jun 1, 2008 - A simple rule change could improve access and quality of care while reducing inequities between compensation for E/M services and for procedures.

Family Practice Management : Opinion

https://www.aafp.org/fpm/2008/0600/p9.html

How We Improved Our Practice and Our Bottom Line With a New EMR System -- FPM

Aug 1, 2008 - This four-physician practice has good reason to be enthusiastic about new technology.

Family Practice Management : Articles

https://www.aafp.org/fpm/2008/0700/p25.html

Coding & Documentation - Jul 2008 -- FPM

Aug 1, 2008 - ...to attach modifier 25 to the evaluation and management (E/M) code when an injection is also performed? For example, I have been coding 99213-25 with 90772. A Yes. CPT instructs that modifier 25 may be reported when a significant and separately identifiable E/M service is provided...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2008/0700/p43.html

Breaking Even on Four Visits Per Day -- FPM

Jun 1, 2007 - Spurning health plan contracts enabled this practice to dramatically reduce overhead and fees while improving access for the uninsured.

Family Practice Management : Articles

https://www.aafp.org/fpm/2007/0600/p19.html

What Every Physician Should Know About the RUC -- FPM

Feb 1, 2008 - A small group of physicians has a big say in what you get paid.

Family Practice Management : Articles

https://www.aafp.org/fpm/2008/0200/p36.html

Coding & Documentation - Jan 2008 -- FPM

Jan 1, 2008 - ...The most current Medicare utilization data for family medicine indicates that 58 percent of established patient office visits were coded 99213 and 28 percent were coded 99214. Forty-three percent of new patient visits were coded 99203 and 27 percent were coded 99204. This data is...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2008/0100/p43.html

Virtual Office Visits: A Reachable and Reimbursable Innovation -- FPM

Oct 1, 2007 - They're convenient, they're efficient, and for a growing number of physicians, they pay.

Family Practice Management : Articles

https://www.aafp.org/fpm/2007/1000/p20.html

Coding & Documentation - Nov 2007 -- FPM

Dec 1, 2007 - ...Can I report office visit code 99213 with modifier -25 and code 90805 for psychotherapy at the same visit? A No. Code 90805 reports that psychotherapy and medical E/M services were provided on the same date, which includes evaluation and management of comorbid conditions, drug...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2007/1100/p15.html

Coding & Documentation - Oct 2007 -- FPM

Oct 1, 2007 - ...A injection, can I bill for the visit (99213), the vaccine (90632, Hepatitis A vaccine, adult dosage, for intramuscular use) and the vaccine administration (90471) at the same time? A Yes. You will need to append modifier -25 to code 99213 in this scenario to indicate that your work...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2007/1000/p15.html

Coding & Documentation - Jul 2007 -- FPM

Aug 1, 2007 - ...Can I code 99213, 69210 and 93000 at the same visit? A Yes. You should append modifier -25 to the evaluation and management (E/M) code, but you should not need additional modifiers for 69210, removal impacted cerumen (separate procedure), one or both ears, or for 93000,...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2007/0700/p24.html

Coding & Documentation - Sep 2007 -- FPM

Sep 1, 2007 - ...that … under existing CPT codes and Medicare rules, a physician could furnish a medically necessary face-to-face E/M service (e.g., CPT code 99213 or similar code depending on the level of complexity) to a particular patient that is observed by other patients. From a payment...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2007/0900/p12.html

How to Analyze Your E/M Coding Profile -- FPM

Apr 1, 2007 - Your peers have been coding more 99214s. Is it time to review your coding habits?

Family Practice Management : Articles

https://www.aafp.org/fpm/2007/0400/p39.html

How to Document and Bill Care Plan Oversight -- FPM

May 1, 2005 - This article will describe how to bill for and document care plan oversight, balancing it as a billing opportunity and a compliance risk. It will include a form for documenting CPO.

Family Practice Management : Articles

https://www.aafp.org/fpm/2005/0500/p23.html

Making Sense of Preventive Medicine Coding -- FPM

Apr 1, 2004 - Find out how to properly code and bill for the preventive services you provide.

Family Practice Management : Articles

https://www.aafp.org/fpm/2004/0400/p49.html

Coding & Documentation - May 2007 -- FPM

May 1, 2007 - ...99213 or 99214? Three Tips for Navigating the Coding Conundrum Don't Get Burned Coding Common Skin Procedures An Update on Certifying Home Health Care Editor's Collections Coding Medicare Medicare Annual Wellness Visits Coding & Documentation Related Topic...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2007/0500/p16.html

Coding & Documentation - Nov 2006 -- FPM

Dec 1, 2006 - ...99213 or 99214? Three Tips for Navigating the Coding Conundrum The 2021 Office Visit Coding Changes: Putting the Pieces Together An Update on Certifying Home Health Care Editor's Collections Coding Medicare Medicare Annual Wellness Visits Coding & Documentation...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2006/1100/p27.html

Coding & Documentation - Oct 2006 -- FPM

Oct 1, 2006 - ...99213 or 99214? Three Tips for Navigating the Coding Conundrum Sports Physicals: A Coding Conundrum In Support of Buprenorphine Deregulation Editor's Collections Coding & Documentation Related Topic Searches Time-based coding MOST RECENT ISSUE Nov-Dec 2020...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2006/1000/p29.html

In Search of a Super Superbill -- FPM

Sep 1, 2006 - This superbill incorporates the best characteristics of superbills submitted by FPM readers.

Family Practice Management : Articles

https://www.aafp.org/fpm/2006/0900/p43.html

Time Is of the Essence: Coding on the Basis of Time for Physician Services -- FPM

Jun 1, 2003 - Sometimes, coding is almost as simple as looking at the clock.

Family Practice Management : Articles

https://www.aafp.org/fpm/2003/0600/p27.html

Coding Level-IV Visits Without Fear -- FPM

Feb 1, 2006 - Use this worksheet to quickly assess whether you can code a 99214.

Family Practice Management : Articles

https://www.aafp.org/fpm/2006/0200/p34.html

News & Trends - Jul 2006 -- FPM

Aug 1, 2006 - ...changes would result in increased payments for many evaluation and management (E/M) services. For example, the Medicare allowance for code 99213 would increase $6.83, while the allowance for code 99214 would increase $7.58. (See the accompanying table.) Payment for many hospital and...

Family Practice Management : News Briefs

https://www.aafp.org/fpm/2006/0700/p20.html

Coding & Documentation - Jul 2006 -- FPM

Aug 1, 2006 - ...and give referrals when appropriate. We also plan to write individual progress notes for each patient. Would it be appropriate to bill 99213 or 99214, along with 99499, Unlisted evaluation and management (E/M) service, if our documentation meets the criteria for these codes? A At...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2006/0700/p25.html

Same-Day E/M Services: What to Do When a Health Plan Won't Pay -- FPM

Apr 1, 2006 - These ideas will help you deal with the difficult consequences of this common policy.

Family Practice Management : Articles

https://www.aafp.org/fpm/2006/0400/p58.html

Coding & Documentation - May 2006 -- FPM

May 1, 2006 - ...In the past, I have always billed 99213 with CPT injection code 90782 and HCPCS injection codes J1100 and J1030. Recently, the insurance company has denied the office visit as invalid with CPT code 90782. What are we doing wrong? A First, 90782 is not valid in 2006; instead use...

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2006/0500/p32.html

News & Trends - Apr 2006 -- FPM

Apr 1, 2006 - ...under Medicare has increased from 20 percent in 2002 to 25.6 percent in 2004, according to data from CMS. The percentages for codes 99212 and 99213 have decreased. View/Print Table Medicare allowed services provided by family physicians 200220032004 E/M codeNumberPercentage of...

Family Practice Management : News Briefs

https://www.aafp.org/fpm/2006/0400/p26.html

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