Gastroenterology Coding Alert
New PCM Codes Apply to 1 Physician, CMS Says
Question: There are multiple gastroenterologists at our practice. Can the physician who’s overseeing a patient’s care for a chronic condition use the codes describing principal care management (PCM)? Can multiple gastroenterologists within our practice bill using this code? Michigan Subscriber Answer: Depending on the circumstances, the gastroenterologist overseeing the patient’s care may use the codes, but only one provider can bill for a specific condition, according to an update from CMS fiscal year 2020 Medicare Physician Fee Schedule final rule. Background: PCM describes care management services for one serious chronic condition, which you will be able to document using HCPCS codes G2064 (Comprehensive care management services for a single high-risk disease, e.g., Principal Care Management … physician or other qualified health care professional …) and G2065 (… clinical staff …). CMS has yet to release a national coverage determination that might define what a “high-risk disease” truly is, so further details of how to use these codes may remain to be seen.
Gastroenterology Coding Alert
- CPT® 2021:
E/M Changes: Will GI Practices Benefit From Next Year's E/M Changes?
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Could Modifier Audits Sink Your Practice's Claims Accuracy Rate?
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How Do We Differentiate Ligation from Excision?
Question: Our GI physician typically documents hemorrhoid “ligations,” but this week we got a chart [...] - Reader Question:
New PCM Codes Apply to 1 Physician, CMS Says
Question: There are multiple gastroenterologists at our practice. Can the physician who’s overseeing a patient’s [...] - Reader Question:
Don't Let Noncovered Diagnoses Trip up Your Coding
Question: Does Medicare restrict coverage to only the diagnoses listed under the code’s Local Coverage [...]
