With the new year come new medical billing codes. Although the codes introduced in 2017 may cause a bit of extra work for the billing professional who is not yet familiar with them, they also offer opportunities to generate significant revenue for medical practices of all sizes and types. Of course, proper use of these new codes is of primary concern in the healthcare industry.
Although the guide below is far from comprehensive or complete, the following codes and modifiers took effect January 1, 2017, And they can significantly affect how you do bill claims for your medical practice.
Add-on prolonged E/M services
2017 brings new billing opportunities for the work that providers complete behind the scenes. The Centers for Medicare & Medicaid Services (CMS) has activated two current procedural terminology codes that pay for prolonged E/M services before and/or after direct patient care that do not require direct face-to-face patent interaction. Use…
- Code 99358 for the first hour of such services, and
- Code 99359 for each additional half-hour
New codes for health risk assessments
Effective since January 1, two new codes are available to help capture practice expenses for health risk assessments.
- Code 96160 covers costs for the administration of health hazard appraisals and other patient-focused health risk assessment instruments that include both scoring and documentation.
- Code 96161 covers costs for the administration of depression inventories and other caregiver-focused health risk assessment instruments for the benefit of the patient that include both scoring and documentation.
Not to be confused with base codes for preventive measures such as annual wellness visits, these codes apply only to health risk assessment instruments that fall beyond the scope of the routine check-up.
New distance medicine codes
Whether using voice or voice and video technology, distance medicine practices and methodologies are certainly on the rise. Capitalize on this trend by using the following codes:
- New place of service (POS) for telehealth services: 02 – Used to report visits by telephone, this code allows practices to bill telehealth services at facility rates.
- New modifier: 95 – This modifier designates the delivery of synchronous telemedicine services through a real-time interactive audio and video telecommunications system. It can be identified by the presence of a new “star” symbol.
Related Article: 3 Most Commonly Denied Invalid Modifier Combinations
Other new codes
As a practice administrator or a medical billing professional, you may also be interested in learning more about the following additions to the 2017 coding system.
- New abdominal aortic aneurysm (AAA) screening code: 76706 – Replacing the old AAA screening code, G0389, code 76706 covers cardiac ultrasounds of the abdominal aorta. All patients with a family history of AAA and male smokers between the ages of 65 and 75 are eligible for a screening under code 76706. Patient deductible and coinsurance for these services will be waived.
- Modifier FX: X-ray taken using film – Reflecting a modern industry trend toward digital x-rays, the FX modifier must be attached to all x-rays that use film, resulting in an applicable payment reduction for payments made under the Medicare Physician Fee Schedule.
- New specialty code for hospitalists: C6 – Reflecting HealthLeadersMedia data that indicates a 43 percent increase in the number of hospitals using hospitalists since 2003, this new specialty code for the burgeoning medical designation went into effect on April 1, 2017.
M-Scribe Technologies, LLC, is a leading provider of medical billing, coding and RCM audit services that serves a wide range of solo physicians, private practices, group practices, multi-site medical organizations, multi-specialty clinics, and hospitals across the United States. For more up-to-date information about recent medical coding changes or to schedule a free medical billing analysis, contact an M-Scribe representative by phone at 770-666-0470 or by email at firstname.lastname@example.org.