For better or worse, codes determine your reimbursement. Correct coding also keeps the auditors away.
The WSMA provides guidance on CPT, ICD-9 and HCPCS coding and billing below. For additional, personalized assistance from WSMA's certified coders, contact our Physician Practice Helpline. Having trouble resolving a claim with an insurer? Check out WSMA insurance claim assistance (for WSMA members only).
OneHealthPort: Administrative simplification guidelines
Virtual Credit Cards
Medicare CMS MLN guidance: Transitional care management
Medicare CMS MLN guidance: Chronic care management
WSMA coding guidance: Summary of care management services
WSMA coding guidance: CCCC and TCM codes for 2013
AAFP tools for transitional care management
CMS Med Learn Matters on annual wellness visits (AWV)
CMS quick reference: ABCs of providing the annual wellness visit
CMS quick reference guide on preventive services
AAFP question & answers on the annual wellness visits
"Computer-assisted coding: Boon for physicians’ practices?" – WSMA Reports article, May/June 2012
CMS ICD-10 Resources
Health data consulting – Dr. Joe Nichols
WSMA insurance claim assistance (for WSMA members only)
WSMA white paper: Medicare Advantage Risk Adjustment Program
CMS MLN: "Preparing/Maintaining Legible Medical Records"
CMS fact sheet: "Medicare Claim Submission Guidelines"
Preventive vs. Sick Visit: How and When to Use Modifier 25!
WSMA resource (revised Oct. 2017) – Telemedicine: Coding and Billing Guidance