Practice Coding Overview
The AAAAI offers coding resources for the practicing allergist / immunologist. Check back often to review recently asked coding questions. For specific coding questions or concerns, contact firstname.lastname@example.org.
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Correctly Coding your Patient Care Encounters
In this free one-hour webinar from May 31, 2023, “Correctly Coding your Patient Care Encounters,” AAAAI Coding Consultant Teresa Thompson, CPC, CMSC, reviews commonly used codes and the documentation necessary to support their billing, correctly using Modifier 25, and Evaluation and Management coding. Upon completion, attendees can claim up to 1.00 AMA PRA Category 1 Credit.™ Review the PowerPoint
Review 2023 CMS values for commonly used allergy/immunology codes
2022 version of Coding and Billing Basics now available
AAAAI Coding Consultant Teresa Thompson, CPC, CMSC reviews 2023 Coding Updates in this one-hour webinar. Download the power point here. For revised allergy/immunology code values, click here.
To Review the Centers for Medicare and Medicaid Services (CMS) Medicare Physician Fee Schedule Relative Value Units (RVUs) click here. The Calendar Year (CY) 2023 conversion factor (CF) is $33.8872 - a reduction from the CY 2022 CF of $34.61.
Did you miss the 2022 Practice Management Workshop? Access these recordings to review coding principles and coding updates for allergy practice.
Billing 101 – Deborah Grider, CDIP, CCS-P, CPC, CPC-I, CPC-C, COC, CEMC, CPMA and Ewa Schafer, MD, FAAAAI
This session will provide the basics in medical coding for young allergists or practice managers with minimal exposure to allergy/immunology coding principles.
Coding Documentation Pearls – Deborah Grider, CDIP, CCS-P, CPC, CPC-I, CPC-C, COC, CEMC, CPMA
An overview of the most recent coding updates for allergy practice.
May 11, 2022
Are you confident you are coding medical care and service correctly? Review requirements and case studies for documenting office and outpatient evaluation and management (E/M) services in this webinar, featuring AAAAI Coding Consultant Teresa Thompson. Review the power point here.
January 1, 2022
Review new allergy / immunology codes.
Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System:
Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
April 20, 2021
Review key changes to documentation for office and outpatient E/M services, and telemedicine and non-physician provider billing practices. Watch this one-hour webinar and earn 1 CME credit. Review the power point. Presented by AAAAI coding consultant Teresa Thompson, CPC, CMSCS, CCC, and moderated by Andrew Murphy, MD, FAAAAI, Chair of the AAAAI Office of Practice Management.
2021 E/M & Coding Webinar – Practical Tips for your Practice
As part of its efforts to reduce burden and improve payment for cognitive care, the Centers for Medicare and Medicaid Services (CMS) implemented key changes to office and outpatient evaluation and management (E/M) services, effective January 1, 2021. Watch this January 26, 2021 webinar featuring renowned AAAAI Coding Consultant Teresa Thompson, BS, CPC, CMSCS, CCC, for key changes in documentation of office and outpatient E/M services you need to make now.
2021 E/M Coding Update Practice
The AAAAI has created this online opportunity to practice evaluating patient cases and coding visits based on medical decision-making and/or time.
January 14, 2021
On January 14, 2021, the Centers for Medicare and Medicaid Services (CMS) released a fact sheet, Physician Fee Schedule (PFS) Payment for Office/Outpatient Evaluation and Management (E/M) Visits that provides additional information and guidance on recent changes to E/M services as a result of the CY 2021 PFS final rule.
Complex Care Add-on Code
In the CY 2021 PFS, CMS finalized an “add-on” code for visit complexity, HCPCS G2211. However, payment for the code was delayed under the Consolidated Appropriations Act, 2021, until January 1, 2024 or later. According to the CMS notice, “Practitioners may report this code for qualifying visits furnished on or after January 1, 2021, although we assigned a PFS payment status indicator of ‘B’ (Bundled) until 2024.”
Implementation of this add-on codes is anticipated to increase reimbursement for Allergy/Immunology professionals and other cognitive specialties. Therefore, we encourage AAAAI members to report this code with their E/M services (i.e., CPT 99202 – 99215). This will help CMS understand how the code would be used, as well as revise its budget neutrality estimates when the code is able to be reimbursed in CY 2024.
Medical Review of E/M
CMS also discusses medical review when practitioners use time to select visit level, stating that, “Our reviewers will use the medical record documentation to objectively determine the medical necessity of the visit and accuracy of the documentation of the time spent (whether documented via a start/stop time or documentation of total time) if time is relied upon to support the E/M visit.”
It is necessary to appropriately document time in the medical record when it is used for E/M code selection. This may be supported through available audit tools as part of an electronic health record (EHR).
December 17, 2020
In anticipation of revised 2021 Evaluation/Management (E/M) codes, the AAAAI offers these current and anticipated resources:
Effective January 1, 2021, the Current Procedural Terms (CPT®) codes 99202-99215 will no longer require history components and/or exam components to determine the level of code to be selected. Changing these documentation requirements will reduce note “bloat” without impeding good patient care. The provider will need to document only relevant history and perform only relevant exam(s), necessary for appropriate patient care, as determined by the provider reporting the service.
In 2021, CPT code 99202-99215 selection will be based on either medical decision-making or time. The provider reporting the service will have the option to choose either time or medical decision-making to support the reported E/M level. Time will now be total time spent on the date of the encounter involving the provider’s time whether it is face to face time or non-face to face time involved in the patient’s care.
These changes reflect the goals of the 2017 Patients Over Paperwork initiative as advanced by the Centers for Medicare and Medicaid Services (CMS) to:
- Put patients first;
- Establish internal processes to evaluate and streamline regulations;
- Enhance efficiency; and,
- Improve the patient experience
With goals to:
- Bring satisfaction to users (clinicians, institutional provide health plans etc.)
- Reduce the amount and hours spent on CMS-mandated compliance
- Increase the number of tasks CMS customers can do digitally
In 2020, the American Medical Association followed the lead of CMS and changed the requirements for New and Established patient evaluation and management codes [99202-99215]. The real benefit and driving force behind Patients Over Paperwork is optimizing workflows so that clinicians can focus on patients, not paperwork.
2023 Allergy/Immunology CPT Superbill Template »
New 2023 Codes »
Review 2022 CMS values for commonly used allergy/immunology codes here »
Use of Telemedicine during the COVID-19 Pandemic »
Frequently Asked Coding Questions »
New 2022 Codes »
New 2021 Codes »
New 2020 Codes »
Preview of 2021 Revised E/M and Other Coding Guidelines »
Medicare Payment, E/M Coding and RAC Updates January 2020 »
RAC Webinar Slides January 2020 (PDF) »
RAC Webinar Questions and Anwsers January 2020 (PDF) »
RAC Webinar Recording January 2020 »
E/M and Procedural Coding Case Studies »
ICD-10 New Codes for 2020 »
Advance Beneficiary Notice of Non-coverage (ABN) »
Advance Beneficiary Notice of Non-coverage (ABN) »
Clarifying MUEs for CPT Code 95165 »
Coding for Bee Immunotherapy »
Coding for Chronic Care Management »
Coding for Penicillin Testing »
Chronic Care Management Services »
CMS and Medically Unlikely Edits »
Helpful Websites for Correct Coding »
ICD-10 Coding »
Practice Management Resource Guide: Chapter 6: Coding and Billing Basics »
Summary of AAAAI Payer Correspondence and Responses »
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Check back often for new information and to review recently asked coding questions. For specific coding questions or concerns, contact email@example.com.