Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains the significance of reporting social determinants of health (SDoH) with examples related to health literacy, environmental factors, and living conditions.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert.
Encephalopathy refers to any disease of the brain that alters its function or structure. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, breaks down documentation requirements and ICD-10-CM coding for toxic, acute, and chronic encephalopathy.
Modifier -25 is used to report a significant, separately identifiable E/M service by the same physician. Courtney Crozier, MA, RHIA, CCS, CDIP , reviews the American Medical Association’s guidance on correct reporting of modifier -25, and outlines when and how to report it.
CMS published its first quarter 2023 HCPCS Application Summaries and Coding Recommendations April 27, which summarizes the final decisions on HCPCS Level II code assignments. CMS created 58 new HCPCS codes, deleted seven codes, and revised one code. Most changes will be implemented July 1.
Q: A patient with a history of prostatic hypertrophy and dysuria receives a laparoscopic prostatectomy conducted with robotic assistance. Which CPT code would be used to report this?
Laura Evans, CPC , takes a deep dive into four CPT Category III codes that were released in the 2023 CPT Manual . Those codes are used to report cutting-edge regenerative musculoskeletal procedures, the use of animal implants, and facet joint replacements.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Pain treatment procedures for trigger point injections have a history of high denial rates. Julia Kyles, CPC , offers insight on what coders and physicians can do to improve reporting of these procedures.
Q: Which CPT code would be reported for an emergency department (ED) visit for an asthma patient experiencing exacerbated symptoms and released with a prescription for treatment?
Atrial fibrillation is the most common type of cardiac rhythm disorder in the U.S. This article defines the condition, reviews relevant ICD-10-CM coding guidelines, and provides documentation and reporting guidance from experts. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shockwave intravascular lithotripsy treats areas of severely calcified coronary arteries. Jane Arbogast-Schappell, CCS, CPC, CCC, CIRCC, explains the procedure and how to report it in HCPCS with coding examples.
CMS released the fiscal year (FY) 2024 IPPS proposed rule on April 10. The document contains proposals for 395 new, 12 revised, and 25 invalidated ICD-10-CM codes.
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.
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.
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.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS , discusses how the 2023 ICD-10-CM guidelines update the instructions for reporting intraoperative care complications.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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 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.
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.
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.
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?
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?
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.
