First Healthcare Compliance hosted an informative webinar, “2017 Procedural Codes Update A-Z” with Karna Morrow, CPC, RCC, CCS-P, Manager of Consulting for Coding Strategies, our valued partner.  Click here to view the webinar.

Highlighting her take home points from the webinar, Karna provides answers to commonly asked questions regarding CPT coding and documentation.

What are the documentation requirements for moderate sedation and is it true it can now be billed with all procedure?

Moderate sedation is now reported in 15 minute increments and is no longer bundled into the procedure.  This will reduce the duplicate reporting by the physician and the facility.

When must the modifier -95 be used and which location will use the associated Place of Service 02 beginning Jan. 1, 2017?

This new modifier and place of service relate to telemedicine and have greatly expanded the opportunity to accurately report these services.  There are different rules for each side of the communication – sender and receiver – that need to be considered.

What is the difference between body regions, body systems, and body structure as required for the PT evaluations?

PT evaluations, and the new athletic training assessments will be modeled after the EM body areas/body systems and the note requirements will be familiar to those who currently report the EM services.

Did they really change the drug screen lab codes AGAIN?

Consistency is the name of the game – yes, they’ve changed the codes AGAIN.  The AMA has provided an extensive dictionary within the code book to assist with deciding the most appropriate code.