Coding managers use risk assessments to measure their level of compliance with laws, regulations, and internal policies and procedures. Learn about the steps involved in E/M risk assessments and practices used to address E/M coding and billing errors.
The 2021 update to the ICD-10-CM code set introduced 43 new codes to Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. Review new codes for sickle-cell diseases, hemolytic anemias, and cytokine release syndrome.
In a year of unprecedented disruption and uncertainty, coding productivity managed to hold steady, according to the results of our 2020 Coding Productivity Survey. Learn how facilities adapted and how yours compares.
Read about regulatory updates in the 2021 Medicare Physician Fee Schedule final rule impacting CPT coding for chronic and transitional care management services, and billing for COVID-19-related services.
This article details 2021 updates to CPT® codes for medicine services including several new codes for continuous electrocardiogram (ECG) recordings and auditory-evoked potentials (AEP), as well as American Medical Association (AMA)-approved CPT codes for COVID-19 immunizations.
Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them.
The calendar year 2021 Medicare Physician Fee Schedule (MPFS) final rule will have a significant impact on physician health systems. Review the implications of updated coding and payment policies that will boost payment for certain E/M services and cut the Medicare conversion factor by 10.2%.
In this article, Laura Evans, CPC, reviews 2021 E/M coding for outpatient encounters based on provider documentation of medical decision-making (MDM). She breaks down the four levels of problems addressed and describes the types of conditions that would fall into each category.
Modifiers provide a means by which a physician or facility can flag a service that has been altered by a special circumstance but has not changed in definition or code. Break down CPT guidelines for reporting hospital modifiers -25, -50, -59, -LT, and RT.
A multi-organizational collaborative is proving further evidence of the growing interest in behavioral health integration with primary care. Read about organizational efforts to improve collaboration between primary care and mental health providers and enhance billing for behavioral health services.
Public comments on 2021 Medicare Physician Fee Schedule (MPFS) proposed rule offer insight into the policy preferences of the medical practice industry. Familiarize yourself with controversial proposed policies to restrict telehealth billing and reduce payment rates for audio-only E/M services.
The COVID-19 public health emergency has not made it easy, but coders and medical practice staff have a lot to be proud of this year. Review key findings from a medical practice salary survey, including data to support medical staff pay increases and expanded job responsibilities.
In a recent National Correct Coding Initiative (NCCI) update, CMS rolled back many of the procedural edits that it temporarily extended in light of the novel coronavirus public health emergency. Read up on the changes, including 291,274 procedure-to-procedure edits, which took effect October 1.
On January 1, new patient office visit code 99201 will be deleted from the CPT code set and coders will find revised descriptors for E/M codes 99202-99205 and 99211-99215. Read about how these changes will impact E/M leveling, medical decision-making (MDM), and code selection for outpatient visits.
Outpatient coders should be familiar with CPT reporting for knee surgeries based on information in the operative note. This article reviews the anatomy of the knee joint and CPT coding for arthroscopic and reconstructive procedures used to visualize and treat common knee conditions.
Q: When would it be appropriate to report modifier -58 (staged or related procedure or service by the same physician during the postoperative period) for a procedure performed during the postoperative period?
CMS is moving forward for E/M changes for physician billing according to the 2021 Medicare Physician Fee Schedule. Read about those changes, as long as a preview of new CPT codes that will be added for 2021.