MDM, E/M Code with Injection Codes

Q. I was approached by a member of the hospital billing department who does urgent care (office based practice) and emergency department billing about a coding question. As the medical director, they asked for my thoughts and support. It’s nice to work at a place that includes the docs! The question revolves around prescription drug management within the management options under the medical decision making (MDM) section pertaining to E/M calculation. We currently do not …

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Consult Codes, Injection Codes, and Coding for Diabetes Education and In-House Dispensing

Q. My codes for consults seem to suddenly be getting denied as invalid. I checked my CPT book, and the codes are still listed as valid. What’s going on? Question submitted by multiple urgent care billers A. Yes, you are right that the consultation codes (99241-99245, 99251-99255) are still valid per CPT, as published by the AMA. CMS, however, has decided to no longer reimburse for those codes and has now changed the status indicator …

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