Great Medical Billing News for Physicians

A positive medical billing change is on the horizon for physicians. As of January of 2006, the American Medical Association (AMA) released new care plan oversight CPT codes and definitions. These medical billing changes will expand the flexibility and usage of these old codes.

There are three major evaluation and management changes that will occur. The first medical billing change is the introduction of two care plan oversight codes. These new codes are different because they do not require a patient to be under the care of a home health agency, nursing home, or hospice. In 2005, the stipulation in medical billing was that the patent must be in one of these three locations to bill.

Another medical billing change is the clarification of modifier 25. It will now state that information must be submitted with a claim if a separate evaluation and management exam is charged. The new 2006 release will make the modifier much simpler to bill because it will be more descriptive. If your medical billing practice sends in chart notes with the claim submission, you may save yourself some much needed time and energy.

The last change deals with consultation codes. The inpatient medical billing consultation codes 99261-99263 (follow up inpatient consultation for an established patient) and the confirmatory consult codes 99271-99275 ( Confirmatory consult for a new or established patient)

Each year the American Medical Association comes up with policies and procedures that are meant to streamline the medical billing process. These three new changes may positively effect the way physician practices do business. The changes leave much of the guesswork out of medical billing. With each year, the American Medical Association creates improved processes that make it very possible for your practice to successfully submit medical billing claims.

View all Articles by: Melissa Clark, CCS-P