Physicians are up against complex payer policies and claims edits, health plans shifting financial burden to patients, and increasing costs of providing health care services. To keep their practices profitable, physicians need to be aware of areas where the profitability of providing services may be diminished. The following steps could help practices avoid financial loss:

While providing an office visit to reevaluate the effectiveness of an asthma care plan, a physician spends 10 minutes addressing the importance of appropriate diet and exercise with the patient, who expresses a desire to lose weight. The evaluation and management (E/M) of stable asthma is reported with code 99213. The documented preventive counseling for diet and exercise is reported with code 99401 (preventive medicine counseling and/or risk factor reduction intervention[s] provided to an individual [separate procedure]; approximately 15 minutes) and adds 1.14 additional non-facility relative value units to the value of the services...

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