The Centers for Disease Control and Prevention (CDC) is monitoring the rapid spread of a novel 2019 coronavirus, formally named COVID-19, first identified in Wuhan, Hubei Province, China. On January 30, the International Health Regulations Emergency Committee of the World Health Organization (WHO) declared the COVID-19 outbreak a public health emergency of international concern due to its sustained person-to-person spread within countries and across continental borders.
CMS recently announced that it will cover acupuncture therapy sessions for Medicare patients with chronic low back pain. Read about how this change will impact physician coding and billing for acupuncture services.
The Centers for Disease Control and Prevention is monitoring the rapid spread of a novel 2019 coronavirus, formally named COVID-19, first identified in Wuhan, Hubei Province, China. Learn about signs, symptoms, and ICD-10-CM coding for the virus. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
More than 34 million people in the U.S. have diabetes and one in five don’t know they have it, according to the Centers for Disease Control and Prevention. In this article, Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC , writes about E/M coding for diabetes management and HCPCS Level II coding for external insulin infusion pumps.
As with any new clinical documentation integrity (CDI) initiative, there are many possible starting points for outpatient CDI. Review advice from healthcare professionals at Trinity Health on how to successfully implement an outpatient CDI program.
The Centers for Disease Control and Prevention (CDC) recently published an ICD-10-CM index and tabular addenda with reporting criteria for new ICD-10-CM code U07.0 (vaping-related disorders). The agency also updated its MS-DRG grouper software package to accommodate the new code.
The Centers for Disease Control and Prevention estimates that over 30 million people in the U.S. have diabetes mellitus and 25% don’t know they have it. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, writes about characteristics of the diabetes and ICD-10-CM coding for the disease.
Nationwide studies show increases in rates of alcohol-related emergency department visits and hospitalizations over the past decade. Review ICD-10-CM documentation and reporting for alcohol abuse and related complications. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coding productivity held steady, but missing documentation and unanswered queries bog down coders, according to the results of our 2019 coding productivity survey
The Medicine section of the CPT Manual includes codes for a variety of services including acupuncture, vaccinations, and behavioral health assessments and is divided into 33 subsections that can make it challenging to navigate.
The Medicine section of the CPT Manual includes codes for a variety of services and is divided into 33 subsections that can be challenging to navigate. Review guidance for reporting 47 new codes within this section of the manual including those for vaccines, behavioral assessments, ocular examinations, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
HCPro’s 2019 coding productivity survey showed that coding productivity held steady for 2019, but facilities continue to struggle with miscommunications between coding and CDI staff and unanswered physician queries.
CMS recently rescinded Transmittal 4880, January 2020 Update of the OPPS, and replaced it with Transmittal 4494 to include updated language on the removal of procedures from the inpatient-only list and new information on out-of-pocket costs for screenings with electrocardiography. All other information remains the same.
The American Medical Association introduced new CPT codes for long-term electroencephalogram (EEG) monitoring sessions that went into effect on January 1. Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how to accurately apply these codes based on details in provider documentation.
Q: A physician performed a pleural catheter flush using saline with manual clearance of clots under ultrasound guidance. Should we bill an E/M code for an outpatient office visit or report this using other CPT codes?
The flu vaccine is changed each year based on the virus types that the Centers for Disease Control and Prevention estimates will be the most prevalent. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC , reviews CPT and ICD-10-CM coding for this year’s flu vaccine and its administration.
Modifier -25 can cause frustration as it is not recognized by many payers, including Medicaid. When applying this modifier, coders must consider CPT reporting rules and adhere to potentially restrictive billing rules followed by payers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The 2020 edition of the National Correct Coding Initiative (NCCI) Policy Manual features new guidance and clinical examples to help coders appropriately apply the -X{EPSU} modifiers debuted by CMS several years ago.
The 2020 update to the CPT Manua l includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
If you aren’t yet confused by the site-neutral payment policy changes prompted by CMS apparently ignoring both Congressional intent and the American Hospital Association (AHA) and other impacted hospitals filing suit, you are likely to become so now.
Although the dollar figures aren’t big, the Office of Inspector General’s (OIG) report on faulty chronic care management (CCM) billing should be concerning for physician practices billing these codes.
The American Medical Association released its annual update to the CPT code set in September, introducing several new codes for cardiovascular and digestive procedures. Review the new 2020 CPT codes for preperitoneal pelvic packing, hemorrhoidectomy procedures, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CDIP, CCDS , reviews updated policies in the 2020 Medicare Physician Fee Schedule final rule that will affect ICD-10-CM risk-adjustment reporting and documentation for facilities.
In the 2020 Medicare Physician Fee Schedule final rule, CMS proposes to adopt four new time-based HCPCS codes to be used in place of existing CPT codes for complex and non-complex chronic care management (CCM) services.
Because the cardiovascular system circulates oxygen and nutrients to all body parts, procedures of the cardiovascular system can be complex and challenging to accurately report. This article reviews CPT guidelines for reporting ECMO procedures and endovascular interventions in the lower extremities. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , writes about new E/M codes, effective January 1, for patient-initiated services administered by a physician or other qualified healthcare provider.
JustCoding’s sister publication, HIM Briefings, conducted a benchmarking survey to shed light on edit and denial management processes across the industry. Review findings from the survey to see how your organization compares to those across the industry.
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
CPT reporting for surgical heart procedures requires an in-depth understanding of cardiovascular anatomy and terminology. This article reviews CPT reporting for procedures involving cardiac pacemakers and implantable cardioverter-defibrillators based on key details in provider documentation.
Q: A patient presents for routine obstetrical (OB) care following a vaginal delivery. During the visit, the provider performs a postpartum depression screening. Should the depression screening be charged separately from the global OB visit service?
Review finalized changes to relative value units for office visits, new HCPCS codes for chronic care management and opioid treatment services, and future updates to the E/M reporting guidelines.
CPT reporting for surgical heart procedures requires an in-depth understanding of cardiovascular anatomy and terminology. This article reviews CPT reporting for procedures involving cardiac pacemakers and implantable cardioverter-defibrillators based on key details in provider documentation. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Peggy S. Blue, MPH, CCS, CCS-P, CPC, CEMC , reviews the appropriate application of 14 new HCPCS codes that will allow opioid treatment programs to report medication-assisted treatments beginning January 1, 2020.
In the 2020 Medicare Physician Fee Schedule final rule, CMS increased the performance threshold for Merit-based Incentive Payment System (MIPS) eligible providers and finalized its proposal to implement the MIPS Value Pathways (MVP) framework in calendar year 2021.
Q: Does a psychiatrist need to document a physical examination and a review of prescriptions in order to support the reporting of CPT code 90792 (psychiatric diagnostic evaluation with medical services)?
CPT coding for behavioral health can be challenging given the multitude of factors that influence code selection. Review procedural coding for psychiatric diagnostic assessments, psychotherapy, and other mental health services commonly performed in the office setting. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Prader-Willi syndrome (PWS) is a rare genetic disorder that causes significant physical and intellectual abnormalities. Debbie Jones, CPC, CCA , writes about signs and symptoms of PWS and diagnostic and CPT coding for the disorder.
Advances in technology have made it easier for providers to administer remote physiologic monitoring services. However, because these services are relatively new, they remain underutilized and Part B providers have questions on how to accurately report and bill for them.
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule and OPPS final rules approving changes to E/M documentation guidelines, introducing new HCPCS codes, and continuing its potentially unlawful payment policy for drugs purchased through the 340B drug discount program.
As of October 1, approximately 1,080 cases of respiratory illnesses and 18 deaths brought on by vaping have been reported in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). Despite continued research into these cases by the CDC and the U.S. Food and Drug Administration (FDA), the specific cause of these illnesses remains unknown.
In today’s virtual environment, with its focus on flexible schedules, organizing the coding function requires consideration of time zones, team member skills, volume of work, and claim-processing schedules.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
Q: If a patient comes in twice a day over the course of a week to receive an IV infusion of Vancomycin and the same line is used daily, would the coder report one initial infusion CPT code per day?
The Centers for Disease Control and Prevention (CDC) recently released documentation guidance for providers who evaluate patients with symptoms of e-cigarette- or vaping-associated lung injury, as well as official ICD-10-CM coding guidance for reporting these encounters.
Every day, more than 130 people in the U.S. die after overdosing on opioids, according to the National Institute on Drug Abuse. In this article, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about accurate documentation and ICD-10-CM coding for opioid use, abuse, and dependence.
