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Office of Johns Hopkins Physicians

Billing, Coding, Risk Adjustment, CPT 2023

Evaluation and Management (E&M) 2023

Billing and documentation for inpatient, emergency room, consultations, nursing facility, and home services will change effective January 2023.  Details and education materials are available.

Review E&M 2021 Resources Here

Visit Our E&M 2023 Resources Page
CPT E&M 2021

ICD-10Risk Adjustment & Diagnosis Coding

Diagnosis Coding: Accurate diagnosis coding is critical for risk adjustment in the age of value-based care.  It's appropriate to select an ICD-10 code for each active condition during each patient encounter. 

Diagnosis Coding Education
Coding Specificity & Risk Adjustment Factors eLearning
HCC Job Aid

Frailty Coding: Certain health maintenance and screening services may not be appropriate for patients with severe chronic illness.  Use shared decision making to help patients determine whether services are right for them.  Be sure to select diagnosis codes to indicate frailty and other conditions to exclude patients from performance metrics that are not appropriate.

Frailty & Exceptions Coding

Slides – Frailty and Exceptions Coding

Codes - Frailty, advanced illness, quality metrics

CCARE: Providers can request education and assistance with accurate diagnosis coding from the CCARE team or their department coding liaisons.

C-CARES Program - Provider Overview
C-CARES Program - Program Outreach

frailty codes

 

Primary Care Billing and Coding Book

This book reviews basics of Billing & Coding for primary care providers

-E&M Basics
-Coding for Procedures
-Diagnosis (ICD-10) Coding
-Overview of RVUs

Download: 2023 Primary Care Billing and Coding Book

Primary Care Billing & Coding Presentations:
Charging for What You Do
Understanding RVUs and Targets
E&M Basics
2021 E&M and ICD10 Updates - Risk Adjustment for Primary Care
Diagnosis Coding and Risk Adjustment for Primary Care

Johns Hopkins Community Physicians Billing Coding Book

Coding Alert: Newsletter

Coding Alert is a bi-weekly newsletter which reviews coding best practices.
Sample topics include:
-E&M 2021 Office Visit Changes
-Advance Beneficiary Notice (ABNs)
-Preventive Care and Telehealth
-Coding for Diabetes
-Coding for Obesity and Cachexia

Access our newsletter
Johns Hopkins Medicine Coding Alert Newsletter

Billing, Coding, Documentation Webinars

A collection of webinar links with information for billing and coding in telehealth.

Upcoming 2024 Webinars:

10/8/24 12:00-1:00pm - ICD-10-CM Updates - Part 1
10/9/24 12:00-1:00pm -  ICD-10-CM Updates - Part 2
11/19/24 12:00-1:00pm - CY25 Medicare Physician Fee Schedule Final Rule
12/17/24 12:00-1:00pm - 2025 CPT Update Highlights - Part 1
12/19/24 12:00-1:00pm - 2025 CPT Update Highlights - Part 2

Recorded Webinar Library
Johns Hopkins Community Physicians Medical Case Conference Series

Available Monday - Friday: 8:30am - 5pmCoding Help Line

410-735-4107
-E&M Services
-Diagnoses Coding
-Procedure Coding
-Risk Adjustment

Email Us
Johns Hopkins Coding Help Line

  

Medicare Annual Wellness Visits

Annual Wellness Visits (AWV) provide health risk screening, preventive care and wellness counseling.  Medicare covers these annually to assess health risks and complete preventive care like immunizations, counseling, and cancer screening.

Team-based Wellness Visits
The ABCs of the Annual Wellness Visits
Review of Opioid Use During AWVs

RN-Performed Virtual Medicare Wellness Visit [RNP-MWV] - *JHCP ONLY WORKFLOWS*

RNP-MWV Provider Workflow
RNP-MWV Scheduling Workflow
RNP-MWV Visit Workflow

Do these wellness services help patients?
There is evidence that annual wellness visits in older adults leads to better health outcomes, so we encourage annual health assessments and preventive care in all older adults regardless of insurance.

Preventive Care in non-Medicare Patient
USFHP and most commercial plans also cover annual preventive care visits.  Insured adults >65 with another primary payer require different components of "preventive care" services compared to Medicare patients.  These preventive services are billed using 99397 (established patient) and 99387 (new patient).

Annual Wellness Visits >65 vs. Whole Health Exams

Whole Health Assessments
The Whole Health Assessment (WHA), also known as Whole Health Exam (WHE), was developed to ensure annual management of chronic health problems and preventative care.  The WHA is covered once per calendar year for patients with Medicare Advantage.

Whole Health Assessment Epic Workflow
Post Visit WHA Completion Tips & Tricks
2019 Whole Health Assessment Paper Form

AWV Recorded Webinars
New updates include changes to Medicare Wellness Visits / Annual Wellness Visits workflows and forms.  Click the links below to view our recorded webinars on the topic.

5.10.21 - The New Annual Wellness Visit
5.11.21 - Annual Wellness Updates for Clinical Support Staff

Tips & Tricks: MWV/AWV
Tips & Tricks: Medicare Wellness Visits Questionnaire

Health Risk Assessment (HRA)
An HRA form is available on paper in several languages.  Questions appear in the same order as in the Epic Smartset.  Giving patients the paper HRA while waiting for the provider can save time.  The HRA can also be sent to patients as a MyChart message to increase efficiency further.

English
English Alternate (abnormals in red, not for patient use)

Spanish
Simplified Chinese
Korean
Arabic

Explanation of Benefits (EOB) Letter
English version
Spanish version

Other Links & Publications
Effects of screening for geriatric conditions and advance care planning at the Medicare Annual Wellness Visit
Medicare Learning Network; Wellness Visits

Effects of screening for geriatric conditions and advance care planning at the Medicare Annual Wellness Visit
Medicare Learning Network: Wellness Visits

 

Important Links