The 2023 update to the CPT manual had almost every chapter undergoing some form of change. In this article, Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, delves into some of the major changes to E/M coding and considerations for documentation integrity.
Healthcare providers know that denials are not a matter of if, but when. One way to prevent and manage denials is by looking for opportunities to involve other departments.
Coding audits are often a source of irritation in small and large practices alike. This article covers common misconceptions about the auditing process and offers tips from experts on how to correct them.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS , discusses how the 2023 ICD-10-CM guidelines update the instructions for reporting intraoperative care complications.
Receiving payments for rendered physician services relies on clean claim submission with accurate CPT codes. This article reviews common CPT coding and billing errors, their causes, and strategies for preventing them.
The American Medical Association’s (AMA) CPT Editorial Panel recently approved a new vaccine administration code for COVID-19. It also released a summary of panel actions, which includes accepted and deleted code and guideline revisions for July 2023, January 2024, and January 2025.
Coding audits are often a source of irritation in small and large practices alike. This article covers common misconceptions about the auditing process and offers tips from experts on how to correct them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The January 2023 update to the CPT manual had almost every chapter undergoing some form of change. In this article, Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, delves into some of the major changes to E/M coding and considerations for documentation integrity.
CMS has published CPT and HCPCS Level II updates that take effect in April. Review highlights of the code and modifier changes in the April 2023 HCPCS Level II and OPPS updates.
The beginning of March brought the release of the first quarter 2023 Coding Clinic . Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, summarizes key information provided in this publication, including analysis of ICD-10-CM guidelines , code changes, and coding Q&As.
Hypothyroidism is a common chronic disorder that involves the underproduction of the thyroxine hormone. This article defines hypothyroidism, reviews relevant ICD-10-CM codes, and provides insight from experts. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
E/M coding guidelines for emergency department services (CPT codes 99281-99285) were recently updated for the first time in decades. Hamilton Lempert, MD, FACEP, CEDC, reviews these changes, along with coding requirements for many other E/M services.
Though outpatient settings have in some form been reviewed by CDI specialists practically since CDI itself started, this progress remains slow and steady for a reason.
Kathleen M. Romero, MSN, RN, EBP-C, Cynthia Beal, MBA-HCM, BSN, RN, and Renee Pate, MSOL, MSN Ed., RN, CCDS, explain how they implemented a CDI program in their facility’s emergency department and the how establishing this program improved coding accuracy and increased reimbursement.
Limb girdle muscular dystrophy is a group of genetic disorders that cause myopathy of the proximal shoulder and hip girdle muscles. This article reviews the disease, 2023 ICD-10-CM code updates, and relevant coding guidance. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
E/M coding guidelines for emergency department services (CPT codes 99281-99285) were recently updated for the first time in decades. Hamilton Lempert, MD, FACEP, CEDC, reviews these changes, along with coding requirements for many other E/M services.
The American Medical Association introduced E/M updates for 2023 and there are more E/M changes scheduled for 2024, according to the CPT Editorial Summary of Panel Actions. Julia Kyles, CPC, explains several 2023 and 2024 code revisions and additions that coders would benefit from making note of in their CPT manuals.
CMS recently published its fourth quarter 2022 HCPCS Application Summaries and Coding Recommendations. The new codes will be used to report injections and skin substitutes and are scheduled to take effect April 1.
Q: Would a same date admission/discharge E/M code be used for a scenario in which a patient is admitted at 11 p.m. on a Monday, is seen by the provider at 4 a.m. on Tuesday, and discharged at 8 p.m. on Tuesday?
The HCPCS first quarter 2023 update, released in December, introduced several new codes and modifiers for medical products and procedural services. Most of the changes took effect January 1.
Kathleen M. Romero, MSN, RN, EBP-C , Cynthia Beal, MBA-HCM, BSN, RN, and Renee Pate, MSOL, MSN Ed., RN, CCDS, explain how they implemented a CDI program in their facility’s emergency department and the how establishing this program improved coding accuracy and increased reimbursement.
The CPT Editorial Panel made a handful of changes to codes for ocular and auditory system procedures as part of its 2023 update to the code set. This article reviews canaloplasty and auditory osseointegrated implant CPT code revisions and additions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Pam Warren-Brooks, MHA, COC, CPC, explains different types of psychiatric healthcare providers, outpatient facilities, and best practices for reporting psychiatric services using CPT codes.
Tonya Moton, RHIA, CCS, defines social determinants of health coding, explains the challenges of reporting these factors, and outlines how coders and providers can work together to create a positive impact in at-risk communities.
Determine whether your facility needs to change E/M documentation habits and capture different details based on the revisions made by CMS to observation and inpatient reporting in the 2023 OPPS final rule.
Remote therapeutic monitoring is one of the latest services to enter the virtual landscape since the COVID-19 public health emergency began. Debbie Jones, CPC, CCA, defines the services and reviews CPT guidance for reporting them.
Tonya Moton, RHIA, CCS, defines social determinants of health coding, explains the challenges of reporting these factors, and outlines how coders and providers can work together to create a positive impact in at-risk communities.
Q: What are the differences between remote therapeutic monitoring and remote physiologic monitoring and what details should we look for in documentation to report these services with CPT codes?
CMS recently published an FAQ document on the use of drug waste modifiers. The resource addresses how the modifiers affect Medicare policy, to which products they can be appended, billing concerns, and more.
The 2023 Medicare Physician Fee Schedule (MPFS) final rule finalized major documentation and coding changes. This article summarizes new guidance for reporting E/M and telehealth services and a significant cut to physician payments.
This article outlines kidney anatomy, explains percutaneous nephrolithotomy and pyelolithotomy procedures, highlights relevant CPT guidance, and includes insight from experts. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The CPT Editorial Panel released 20 new Category III CPT codes. These new codes, along with two revisions, are mainly for cardiovascular procedures and take effect July 1.
Q: When is it permissible under Medicare to assign CPT add-on code 37186 for a secondary thrombectomy when an atherectomy is performed in the same vascular territory?
This article outlines when and how to report new and revised 2023 CPT codes for arthroplasty and arthrodesis procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The end of the public health emergency (PHE) will bring the expiration of many Medicare waivers issued since 2020. Ronald Hirsch, MD, FACP, CHCQM, CHRI, explains how facilities can maintain their compliance in this new era.
Remote therapeutic monitoring is one of the latest services to enter the virtual landscape since the COVID-19 public health emergency began. Debbie Jones, CPC, CCA, defines the services and reviews CPT guidance for reporting them.
CMS developed the National Correct Coding Initiative (NCCI) to control improper coding and potentially inappropriate payment of Part B services. Review NCCI basics to ensure compliance with the latest coding policies.
Alysia Minott, CIRCC, CCS, CDIP, explains that CPT coding for complex procedures performed using interventional radiology (IR) can be mastered; the first step is learning how to interpret applicable coding guidelines.
With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
Alysia Minott, CIRCC, CCS, CDIP, explains that CPT coding for complex procedures performed using interventional radiology (IR) can be mastered; the first step is learning how to interpret applicable coding guidelines.
The American Medical Association's update to the 2023 CPT code set has brought three code additions, one revision, and one deletion to the integumentary chapter (CPT codes 10030-19499). This article provides procedure descriptions and coding guidance for the new and revised codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The new batch of diagnosis codes and revised guidelines for social determinants of health (SDOH) that will go into effect April 1 highlight the importance policymakers place on collecting this data. Julia Kyles, CPC, provides tips for capturing the SDOH using these new codes.
The Centers for Disease Control and Prevention and the National Center for Health Statistics published updates to the ICD-10-CM coding guidelines and files, which take effect April 1. The updates include 42 new diagnosis codes, seven deletions, and one revision.
Coders can reinforce their understanding of the 2023 CPT E/M medical decision-making (MDM) requirements with tips from Peter Hollman, MD , who oversaw the changes.
The 2023 CPT code update introduced numerous code additions, revisions, and deletions that took effect January 1. This article covers new and revised codes in the respiratory and nervous system chapters of the CPT Manual. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
