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Responds to questions concerning coding and documentation in family practice in the United States. Definition of a self-limited or minor problem; Allergy injections; Code to be used to bill for epoetin alpha given for anemia; Medical decision making score sheets. INSET: HCFA releases new Medicare documentation guidelines, plans ....

Presents a summary of changes relevant to family practice in the United States Health Care Financing Administration's ICD-9 diagnosis codes, which are set to take effect on October 1, 2000. V codes; Maternity and infant care; Allergy and asthma; ICD-9 coding tools that can help family physicians avoid claim denials. INSET: New FPM coding tools.

Focuses on legal issues concerning fraudulent practices in rental arrangements of physician offices in the United States. Issuance of a publication on fraud alert by the Office of Inspector General of the Department of Health and Services; Context of the anti-kickback statute; Evaluation of the three areas of a rental agreement.

Offers advice on how family physicians can avail of a bonus from Medicare for services they provide. Requirements to qualify for the United States Health Care Financing Administration's incentive payment program; Services eligible for the bonus; How to claim the bonus.

Provides information on critical care services for Medicare patients by the United States Health Care Financing Administration. Reduction of the work of relative value units of critical care services; Clarification of medical necessity criteria for critical care; Need to define requirements for documenting time spent with family members.

Advises managed care organizations and doctors in the United States on how to get doctors credentialed more quickly. Causes of delays in credentialing; Need for doctors to apply early; Designation of staff to focus on applications; Negotiations with licensing boards; Strategies in coping with the period before the credentials arrive.

Focuses on CPT changes for the year 2000 that family physicians must take note of. Evaluation and management of emergency care patients; Codes for organ or disease-oriented laboratory panels; Procedural services; Immunization administration codes. INSET: Lab panel changes in CPT 2000.

Advises on what physicians should tell patients regarding the changes in medicare coverage. Things patients should remember about Medicare; Information physicians should know about Medicare managed care plans. INSET: Medicare resources.

Presents key factors to consider when developing incentive plans in medical practices. Variation of incentives from group to group; Limits to incentive plans; Disclosure of incentive information to patients. INSET: Questions to ask about your incentives.

Examines how Medicare defines and covers concurrent medical care. Coverage of concurrent care; Criteria used by Medicare in determining concurrent care; Documentation of concurrent-care claims.

Offers advice to United States family physicians who are employed in organizations, on evaluating various incentive packages. Structure of incentive plans; More frequently used measures; Characteristics of a good compensation package.

Presents information on CPT code modifiers commonly used by family physicians. Use of modifiers for providing additional information on services; Modifier-25 for annual preventive-medicine encounters; Modifier-21 for established patients with multiple, concurrent problems.

Focuses on the introduction of Medicare Current Procedural Terminology (CPT) codes for care plan oversight (CPO) payment to family practice physicians. Presentation of these CPO codes; Outline of Medicare's policy.

Discusses how family practice physicians can reduce the number of their claims, which are denied or rejected for reimbursement, by updating their diagnosis codes. Listing of codes for Maternity care; Presentation of codes for respiratory care and other illnesses; Indication that these codes and others were effective October 1, 1998.

Presents a question and answer segment on reimbursement strategies for family practice physicians. How to comply with prepayment requests for E/M documentation; Whether to bill a consult code if a patient is referred by a chiropractor; Appropriateness of using prolonged services codes (99354-99357) with non-E/M codes.

Reports on the implementation of the 1997 Balanced Budget Act (BBA) for medicare coverage of physician assistants (PA) services in the United States. Advantages of the Act; When the Act will become effective; Provisions of the Act.

Presents a summary on changes in Medicare coverage for clinical preventive services which took effect last January 1, 1998. Continuation of annual screening mammogram for all women over age 39; Categories of beneficiaries qualified for pelvic exams; Types of covered colorectal tests.

Discusses the private contracting provision of the 1997 Balanced Budget Act (BBA) which impact on the way physicians interact with Medicare patients in the United States. Myths that have arisen about the provision and the facts that counter them; Bill introduced in Congress in January 1998 that would repeal the provision.

The article presents questions and answers related to family practice management including billing emergency department visits, the application of transitional care management and Medicare Advantage, and coding for a health coaching service.

The article presents questions and answers related to coding and documentation including immunization administration during preventive visits, can one be paid for "incident to" charges for counseling, and what code describes third and fourth subsequent Medicare annual wellness visits.

The article provides an answer to the question of how government imposes the Social Security Act section 1128(b)(6) to have different fee schedule for privately insured and uninsured patients.

The article presents questions and answers related to diagnosis codes developed by the Centers for Medicare & Medicaid Services including the differences between different smoking cessation codes, eligibility for Medicare annual visit (AWV) and defining a new patient.

The article provides an answer to a question on how a contract negotiations professional can obtain information on work relative value units (RVUs), evaluation and management (E/M) code usage, and other compensation and coding data.

A letter is presented in response to Kent Moore's post "Facing the new face-to-face requirement for Medicare home health services" published on March 11, 2011, on Family Practice Management's (FPM's) "Getting Paid" blog; also presented is the author's response to the same.

The article provides an answer to a question of how to opt back in Medicare in the U.S.

The article provides information related to family practice in the U.S. A tool to help employees understand the total compensation package that the practice provides was implemented. Small stacking bins instead of shelving was used to organize medication samples better and all packaging was stripped except for the package insert.

The article provides an answer to a question of where to send the letters and e-mails of patients concerning Medicare payment reform and the percentage of Medicare budget that represents physicians' payments.

The article provides an answer to a question of alleviating the confusion on a private, fee-for-service Medicare plan implications.

The article provides information related to improving physicians' practices. Physicians can encourage their patients to pay their bills at the time of the visit by training the staff to tell patients the total charge upon checkout. They can use online databases to identify drug-seeking patients. They can also streamline the prescription request process by simplifying refill requests.

A response by Kent J. Moore to a letter to the editor about his article "What's New in Medicare Preventive Benefits" in the February 2007 issue is presented.

Presents a question and answer advisory on Medicare teaching physician rule's primary care exception in the U.S. Provisions of the primary care exception; Inability of resident's documentation to invalidate the claim of supervising physician for a lower level of service; Option of the supervising physician to bill a lower level of service.

The article discusses issues related to the reimbursement for depression care. When a family physicians diagnose patients with depression, they submit psychiatric diagnosis codes with appropriate evaluation and management codes, but they are always denied the reimbursement. The patient's insurance company sends the bill to its mental health services provider, but because family physicians are not a participating psychiatric provider with that company, their claim is denied and the patient gets billed for the service.

The article focuses on a query whether the family physicians and other physicians are restricted to the evaluation and management visit codes. Current Procedural Terminology confirms that family physicians can submit code 90862. Whether they will get reimbursed for it depends on a health plan's payment policy. Some health plans may use mental health and behavioral health carve-outs that preclude payment for 90862 except when billed by a psychiatrist or other designated mental health professional.

The article answers the question regarding submission of code for partner's hospitalized patient. CPT's hospital care codes are "per day" codes, which represent all services provided on that date. Where a physician is on call for or covering for another physician, the patient's encounter will be classified as it would have been by the physician who is not available. Generally, code should not be submitted for attending to partner's patient. However, there are a couple of different situations which allow for different codes to be submitted by different physicians on the same date.

The article presents an answer to the question regarding codes for filling out school physical forms outside of an office visit. There is no such specific CPT code for completing a school physical form outside a visit. According to CPT, 99080 is to be used as an adjunct to the basic services rendered, which means it should not typically be reported by itself. An unlisted CPT code, such as 99199, "unlisted special service, procedure or report," may be considered. Claim form may indicate what service this is intended to represent.

This article focuses on documenting E/M services with checklists. The author states that using checklists to document E/M services is an accepted practice, and he is not aware of any payer that has refused to recognize them as part of the documentation of E/M services. Checklists in and of themselves would be insufficient documentation in most cases. For example, a check mark that indicates an abnormality in the patient's respiratory system upon exam should be accompanied by a notation of the specific abnormality.

Presents updates on the evaluation and management (E/M) codes and documentation guidelines for E/M services. Distinction between the E/M codes and the documentation guidelines for E/M services; Level of service of E/M codes; Changes in the documentation guidelines for E/M services.

Presents a question and answer advisory on the practice of medicine in the U.S. Legality of the productivity-based salary reductions; Protection against fraudulent acts of the hospital; Prevention of embezzlement.

Presents the clarified definition of the criteria in determining the status of the patient as 'confined to the home' for home health agencies in the U.S. Creation of a normal inability to leave home; Restriction in the ability of the patient to leave home without assistive device; Confinement of a paralyzed patient from stroke.

Describes the changes in the CPT codes in 2003. Changes in the coding of routine venipuncture; Musculoskeletal therapeutic injection codes; Changes in colposcopy coding; Laboratory and other services.

Suggests tips to integrate humor in health practice. Approach to maintain sense of humor in the medical practice; Strategies to break out from a routine work; Limitations in applying levity in the workplace.

Focuses on the Medicare payment opportunities for ambulatory blood pressure monitoring and medical nutrition therapy in the U.S. Measurement of blood pressure through a non-invasive device; Expansion of the Medicare coverage for beneficiaries with diabetes and renal disease; Purposes of Medicare.

Provides tips for less costly flu vaccination. Purchase of flu vaccines before flu seasons; Avoidance of buying vaccine supply from a retail pharmacy; Details on the CPT codes for influenza vaccine.

Presents tips on ways to ICD-9 coding for diagnostic tests. Coding of confirmed diagnosis whenever possible; Reporting of unrelated and co-existing conditions as secondary diagnosis; Use of appropriate screening diagnosis code.

Focuses on the changes in the integumentary, musculoskeletal and laboratory codes of CPT. Movement of the fine-needle aspiration codes from the laboratory section of CPT to the integumentary portion of the Surgery section; Application of code to describe a therapeutic injection in to the carpal tunnel; Deletion of the arthritis panel code, 80072.

Presents question and answer advisory related to family medicine in the United States. Conduction of surveys to determine national averages of fees for the Medical Group Management Association; Median staffing ratio for a solo family practice; Privilege of not accepting Medicaid patients at any time.

Presents a question and answer advisory related to medical care. Guidelines to qualify for a given level of medical decision making; Requirements under the incident-to rules in Medicare; Submission of administration code 90471 for immunization.

Presents several misconceptions and facts about medicare in the United States. Payments on Medicare carriers on a contractual basis; Prosecution for coding errors when dealing with Medicare; Privilege to receive payment from a Medicare patient for services excluded from Medicare coverage.

Presents the highlights of the changes in ICD-9 diagnosis coding regarding family physicians. Replacement of the diagnosis code 256.3; Additional of the word acute to 411.81 for the coronary occlusion; Deletion of the diagnosis code 564.0 on constipation.

Reports the medicare payment policy issued by the Centers for Medicine and Medicaid Services to its Medicare carriers in the United States. Features of the directives; Implications of the policy on the medicare coverage services to its members; Details of the instructions enclosed in the directives.