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Posting Date: 01/28/2022
Fee-For-Time Compensation Arrangements
Fee-For-Time Compensation Arrangements Can a physician return to work in his or her practice for a short period of time to reset the 60-day clock requirement for the fee-for-time compensation arrangement provider? Answer: In order for the [...]
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Posting Date: 01/27/2022
Documentation
Documentation What are the basic documentation requirements for a service submitted to Medicare for payment? Answer: For all services submitted to Medicare, the medical record (whether electronic or paper) must clearly define the provider [...]
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Posting Date: 03/18/2022
Consultations
Consultations Does CMS permit payment for consultative E/M services? Answer: CMS permits payment for medically necessary consultative E/M services. The specific E/M codes previously used to represent consultative services were [...]
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Posting Date: 10/10/2024
Complex and Chronic Care - HCPCS Code G2211
Complex and Chronic Care - HCPCS Code G2211 Please define appropriate usage and billing for HCPCS code G2211. Answer: CPT G2211 is an approved add-on code representing complex and/or continuous management in the office and outpatient [...]
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Posting Date: 01/27/2022
Chronic Care Management
Chronic Care Management The guidelines state moderate or high complex MDM. Do the E/M guidelines apply here? Answer: Yes, the E/M guidelines for MDM are applicable, since chronic care management (CPT 99490) is included within the E/M [...]
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Posting Date: 01/27/2022
Advanced Care Planning
Advanced Care Planning Please define documentation requirements when billing advanced care planning (CPT 99497 and 99498). Answer: ACP codes may be used with or without a base E/M code on the same date of service, based on whether a [...]
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Posting Date: 01/28/2022
Admission and Discharge Services
Admission and Discharge Services Is it permissible for an NPP to perform an initial hospital admission or discharge service on behalf of the attending physician, or on a split/shared basis, when both are members of the same provider [...]
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Posting Date: 01/27/2022
Observation Services
Observation Services Please define guidelines for providers billing observation services. Answer: Observation services are ordered, performed and billed by the practitioner (or group), who is responsible for the patient’s care during the [...]
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