Why Internal Medicine billing is different.
Internal Medicine billing expertise.
- Office E/M coding by medical decision-making or time
- Inpatient and observation care billing
- Transitional care management after discharge
- Chronic and principal care management
- Visit complexity add-on code billing
- Advance care planning services
- HCC risk adjustment documentation support
- Nursing facility and home visit billing
Common Internal Medicine codes we work with.
| Code | Description |
|---|---|
99204 | Office or outpatient visit, new patient, moderate level of medical decision-making |
99214 | Office or outpatient visit, established patient, moderate level of medical decision-making |
99223 | Initial hospital inpatient or observation care, high level of medical decision-making |
99495 | Transitional care management, moderate complexity, face-to-face visit within 14 days of discharge |
G2211 | Visit complexity inherent to office or outpatient E/M associated with longitudinal care (add-on) |
99497 | Advance care planning, first 30 minutes, face-to-face with patient, family or surrogate |
CPT® is a registered trademark of the American Medical Association. Codes shown are examples; correct coding depends on documentation and payer policy.
Our processInternal Medicine billing process.
Eligibility and Scheduling
- Real-time eligibility for office and hospital patients
- Post-discharge scheduling for transitional care
- Medicare Advantage and secondary coverage verification
- Copay and deductible collection
Coding
- E/M level review based on medical decision-making
- Hospital and observation service coding
- Care management time tracking
- Diagnosis specificity for risk adjustment
Claim Submission
- Scrubbing for E/M and add-on edits
- Correct place of service for each setting
- Transitional care billed after the 30-day period
- Daily electronic submission
Denial Management
- E/M level and medical necessity appeals
- Care management denial corrections
- Duplicate and overlapping service resolution
- Feedback to prevent repeat issues
Analytics
- E/M distribution by provider
- Hospital versus office revenue
- Care management capture rates
- Payer and aging trends
Internal Medicine billing FAQs.
When can transitional care management be billed?
TCM requires contact with the patient within two business days of discharge and a face-to-face visit within 7 or 14 days, depending on complexity. The service covers 30 days, beginning on the discharge date.
What is G2211?
G2211 is a Medicare add-on code for office visits that are part of ongoing, longitudinal care for a patient's health conditions. It recognizes the added complexity of being the continuing focal point for that patient's care.
How are hospital visits coded now?
Inpatient and observation care share the same code set and are leveled by medical decision-making or total time on the date of service. We code hospital services from your notes using the current guidelines.
Can you help with risk adjustment?
Yes. We review documentation for diagnosis specificity and flag chronic conditions that should be addressed and documented each year, which supports accurate risk scores.