Accurate medical coding for dermatological procedures is essential for proper payment and compliance. This article provides a detailed overview of coding guidelines for excisions and repairs, ensuring that healthcare professionals correctly report these procedures.
CMS recently published its HCPCS Quarterly Update, which brings 148 HCPCS Level II code additions, discontinuations, and revisions. The changes became effective April 1.
In an environment where there is continuous development of new technology for the treatment of medical conditions, the AMA created a third category of CPT codes. Category III codes are a set of temporary codes for reporting emerging technology, services, and procedures. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
The nearly 40,000 new National Correct Coding Initiative edits might seem overwhelming at first, but a divide-and-conquer strategy for the next update can make it more manageable. CMS added dozens of CPT codes to the procedure-to-procedure edits that went into effect January 1, 2025, and medically unlikely edit file that went into effect April 1.
The largest barriers and facilitators to screening, documenting, and addressing adverse social determinants of health across United States’ emergency departments have been identified in a recent study published in JAMA Network Open.
Train new coders to follow CMS’ rules when they find CPT guidance that doesn’t match Medicare’s requirements. This article discusses how the CPT manual’s instructions to report modifier -99 (Multiple modifiers) don’t match instructions from CMS and some Medicare administrative contractors.
Postherpetic neuralgia (PHN) is severe pain caused by damage to the nerves at the area or areas affected by shingles after the rash is resolved. Typically, it is pain that persists four or more months after the initial onset of the rash. For documentation purposes, the physician would need to state which type of PHN the patient has. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Selecting a level of medical decision-making (MDM) is confusing and complicated. In this article, Terry Tropin, MSHAI, RHIA, CCS-P, defines key MDM terms and describes a simplified system for selecting a level of MDM.
Radiologists and providers who implant or program implantable medical devices should review the six new magnetic resonance (MR) safety CPT codes that went into effect January 1, 2025. The codes describe the work involved when a medical implant or metallic foreign bodies create additional risks for an MR exam.
When medical services are rendered, the expectation is that the facility and/or provider will be reimbursed for those services. Sometimes the reality is that a claim will be denied as it “fails to meet medical necessity” by the insurance carrier. It is always in your best interest to appeal all medical necessity denials. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
You may have noticed that people are feeling stressed out throughout the United States. Each individual deals with stress in their own way. Most often, ICD-10-CM diagnosis codes reported for these patients may be a bit vague, especially when you are coding for a primary care physician.
A recent report from the Brown University School of Public Health compared the average commercial price for low-complexity, low-intensity medical care in New York hospital outpatient departments to the same care provided in non-hospital settings, such as physician offices and ambulatory surgery centers.
This article wraps up our coverage of modifiers commonly used by pain management practices that are required by Medicare and private payers when a CPT procedure code on a claim isn’t detailed enough to precisely tell what service or procedure was provided. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
A recent study published in BMC Public Health, found that patients in Colorado diagnosed with long COVID increasingly sought care from outpatient and specialist visits over hospital and emergency department visits.
With the prevalence of diabetes mellitus among the population expected to grow, an overview of the disease may help you keep track of how to code instances of it. This article will cover the different types of diabetes mellitus and a few tips when coding it.
Treating providers can perform audio-only evaluation and management visits via telephone for patients who are at home thanks to the three-month telehealth extension through to March 31, 2025. But remember to follow the rules for audio-only visits in the final 2025 Medicare physician fee schedule.