CMS recently released Transmittal 11737, detailing January 2023 updates to the OPPS. The transmittal offers information on new COVID-19 vaccine and administration codes, dental coding updates, coding clarification, and remote behavioral health service codes.
A urinary tract infection (UTI) is a common bacterial disease that affects the bladder and urethra. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews urinary anatomy as well as diagnostic considerations and ICD-10-CM coding for UTIs.
The 2023 CPT code update introduced an option for reporting nasal valve collapse repairs, as well as revisions to certain injection codes to include imaging guidance.
As of November 16, the CPT Editorial Panel has approved 56 Category I codes for severe acute respiratory syndrome coronavirus 2 vaccines and immunization administration. In this article, Kimberly Lee, M.Ed., RHIA, CCS-P, addresses some of the new COVID-19 product and administration codes.
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.
The CPT Editorial Panel recently announced that it approved new CPT codes for Pfizer’s bivalent COVID-19 vaccine booster and its administration for children six months to 4 years old after they have received administration of the first and second doses of the product.
Q: What is the difference between “normal” and “abnormal” native connections in the descriptors for new 2023 CPT codes 33900-33903 describing percutaneous pulmonary artery revascularization by stent placement?
The 2023 CPT code set takes effect on January 1, 2023. This article covers code changes for bariatric gastric balloon procedures, hernia repairs, and other updates within the digestive system chapter. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Peter Hollman, MD , breaks down 2023 CPT guidance in a new section of the manual for initial and subsequent E/M services, which will impact reporting of hospital inpatient and observation care services beginning January 1.
As of November 16, the CPT Editorial Panel has approved 56 Category I codes for severe acute respiratory syndrome coronavirus 2 vaccines and immunization administration. In this article, Kimberly Lee, M.Ed., RHIA, CCS-P, addresses some of the new COVID-19 product and administration codes.
The American Medical Association recently published CPT codes for 2023, including 103 code additions, 88 revisions, and 69 deletions. This article covers new codes and the single revision made to the cardiovascular system chapter. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare finalized a care management service for chronic pain management (CPM). Effective January 1, CPM services can be reported by a wide range of providers, including primary care practitioners.
The Office of Inspector General (OIG) recently released a report investigating instances of incorrect co-surgery and assistant-at-surgery modifier usage, which found that 69 of 100 sampled procedural services did not meet federal requirements.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC , defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
The 2023 ICD-10-CM update brought many new codes to report injuries sustained from collisions between motorcycles or electric-assisted bicycles and other vehicles, entities, or objects. This article reviews external cause codes and examines the new additions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS confirmed in the 2023 Medicare Physician Fee Schedule final rule that it will adopt the framework of the revised AMA E/M guidelines, including payment based on medical decision-making (MDM) or time, effective January 1, 2023. Laura Evans, CPC, explains how the agency will diverge from the AMA on some points, however.
CMS released its 2023 OPPS final rule on November 1. The document finalizes most proposed policies, including a new provider type for rural emergency hospitals (REH), continued coverage of telehealth services, and implementation of new skin substitute HCPCS codes, among other changes, which largely take effect January 1, 2023.
Diabetes mellitus is a chronic disease that causes elevated levels of glucose in the blood. It invades the body in many different ways. Shelley Safian PhD, RHIA, CCS-P, COC, CPC-I describes the types, manifestations, and treatment methods for diabetes mellitus and how to report them accurately in ICD-10-CM.
Despite CMS’ long-anticipated change in method for selecting E/M visit codes, some physicians and healthcare providers have continued to review 10 or more body systems for every patient. Julia Kyles, CPC explains how this action has some coding professionals wondering if it will prove to be a problem in the long run.
Traumatic brain injuries (TBI) occur after blows, bumps, or jolts to the head disrupt normal brain function. This article covers new codes from the 2023 ICD-10-CM update that pertain to TBIs involving the skull and meninges. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Office of Inspector General (OIG) released a report in October to assess the results of 12 Medicare hospital and identify CMS’ actions as a result of OIG recommendations made in those audits.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC , defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
The 2023 update to the ICD-10-CM code set includes over 60 new codes for intracranial injuries with loss of consciousness, status known. This article covers codes from the 2023 ICD-10-CM update that pertain to traumatic injuries of the brain, specifically the cerebrum, cerebellum, and brainstem.
The ICD-10-CM Official Guidelines for Coding and Reporting provide a roadmap for accurate diagnosis coding. Kimberly Lee, M.Ed., RHIA, CCS-P, unpacks fundamental ICD-10-CM coding concepts.
The 2023 update to the ICD-10-CM code set includes over 60 new codes for intracranial injuries with loss of consciousness, status known. This article covers codes from the 2023 ICD-10-CM update that pertain to traumatic injuries of the brain, specifically the cerebrum, cerebellum, and brainstem. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Flail chest is the most severe type of blunt traumatic chest injury and is likely the most common serious thoracic injury. Debbie Jones, CPC, CCA, explains the symptoms, diagnostic process, and guidelines associated with reporting flail chest.
A coder’s practice should check its telehealth claims against the information in the recent Office of Inspector General data brief on telehealth services, healthcare attorneys advise. Julia Kyles, CPC, reviews the September 2 report, which contains findings and program integrity measures for telehealth services.
CMS recently published Transmittal 11594 , outlining HCPCS codes for drugs that received pass-through status, new proprietary laboratory analysis (PLA) codes for tests, code revisions for pharmaceutical drugs, and skin substitute product codes, all of which became effective October 1.
The American Medical Association (AMA) released the calendar year 2023 CPT code set on September 9. Learn about new codes pertaining to virtual reality technology, cognitive behavioral therapy, and abdominal hernia procedures.
The ICD-10-CM Official Guidelines for Coding and Reporting provide a roadmap for accurate diagnosis coding. Kimberly Lee, M.Ed., RHIA, CCS-P, unpacks fundamental ICD-10-CM coding concepts.
Q: For colonoscopies, is it appropriate in CPT coding to report the excision of several lesions in the same portion of colon separately if they are removed by the same technique?
The Office of Inspector General (OIG) recently released a data brief on billing risks associated with Medicare telehealth services during first year of the COVID-19 pandemic. Julia Kyles, CPC, explains the significance of using the OIG’s data brief and offers tips to adhere to compliance guidelines.
The 2023 ICD-10-CM update, which took effect on October 1, includes almost 1,500 code changes. This article focuses on new codes in Chapter 9, Diseases of the Circulatory System. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Office of Inspector General (OIG) recently released a data brief on billing risks associated with Medicare telehealth services during first year of the COVID-19 pandemic.
Many healthcare systems are looking at how to expand their CDI program to include outpatient and ambulatory settings. Jennifer Boles, BS, COC, CRC, CCDS-O, explores her ambulatory CDI program’s success and offers advice for those looking to expand.
Shelley Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how, beginning in 2023, medical decision-making (MDM) will be used to determine E/M leveling for additional visit services, following similar changes for outpatient visits implemented in 2022.
Shelley Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how, beginning in 2023, medical decision-making (MDM) will be used to determine E/M leveling for additional visit services, following similar changes for outpatient visits implemented in 2022.
Many healthcare systems are looking at how to expand their CDI program to include outpatient and ambulatory settings. Jennifer Boles, BS, COC, CRC, CCDS-O, explores her ambulatory CDI program’s success and offers advice for those looking to expand.
The 2023 ICD-10-CM update features many new, revised, and deleted codes. This article focuses on code changes pertaining to blood/blood-forming organs including new codes for von Willebrand disease, heparin-induced thrombocytopenia, and platelet-activating anti-PF4 disorders.
On August 31, the American Medical Association (AMA) announced eight new CPT codes for bivalent COVID-19 vaccine booster doses. The vaccine boosters are designed to combat both the original COVID-19 strain and omicron subvariants BA.4 and BA.5. Of the eight new CPT codes, four are to be used for Moderna booster vaccines and four are to be used for Pfizer-BioNTech boosters.
Q: How do CPT codes 28295 (correction, hallux valgus, with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method) and 28298 (…; with proximal phalanx osteotomy, any method) differ?
A recent Medicare Provider Compliance Newsletter highlights accurate documentation and CPT coding for total hip arthroplasty (THA) surgery. This newsletter explains relevant codes and reminders when reporting these procedures.
Effective October 1, the ICD-10-CM code set will be updated to include over 1,100 new codes before counting code revisions and deletions. This article covers new codes for musculoskeletal and genitourinary conditions including muscle wasting, rib and sternal fractures, drug-induced neuropathy, and endometriosis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: New ICD-10-CM codes for unspecified vascular dementia with behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety take effect October 1. Do these new codes require linkage and specific documentation by the provider that the conditions are related?
Streamlined coding and shorter time requirements for prolonged services are on the horizon for physicians and qualified healthcare professionals. The pending update to the E/M chapter of the CPT Manual , effective January 1, 2023, will replace four prolonged services with two 15-minute codes.
