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Medical Necessity Comes Before Coding
Manage episode 480953617 series 2490675
The 2021/2023 E/M guideline revisions read: “The evaluation and/or treatment should be consistent with the likely nature of the condition.” Before this, the CPT® guidelines did not discuss medical necessity. Guidance was left to the payers, particularly Medicare, via the Social Security Act.
CMS’s guidance doesn’t necessarily hold regulatory authority. However, it often reflects a new, shared understanding that medical services reported should meet documentation standards for level selection. Those standards should also appropriately indicate why the patient is visiting the provider, based on the presenting problems.
This episode of the CodeCast echoes Terry’s insights that auditors, coders, and medical professionals focus on medical necessity first, then look to coding.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/
The post Medical Necessity Comes Before Coding appeared first on Terry Fletcher Consulting, Inc..
91 에피소드
Manage episode 480953617 series 2490675
The 2021/2023 E/M guideline revisions read: “The evaluation and/or treatment should be consistent with the likely nature of the condition.” Before this, the CPT® guidelines did not discuss medical necessity. Guidance was left to the payers, particularly Medicare, via the Social Security Act.
CMS’s guidance doesn’t necessarily hold regulatory authority. However, it often reflects a new, shared understanding that medical services reported should meet documentation standards for level selection. Those standards should also appropriately indicate why the patient is visiting the provider, based on the presenting problems.
This episode of the CodeCast echoes Terry’s insights that auditors, coders, and medical professionals focus on medical necessity first, then look to coding.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/
The post Medical Necessity Comes Before Coding appeared first on Terry Fletcher Consulting, Inc..
91 에피소드
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