Orthopedists perform injections and aspirations to address a range of ailments, but reporting injections can be difficult. This article reviews proper CPT coding for sacroiliac joint injections and joint arthrocentesis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Physician coders should watch out for recently implemented edits to codes that debuted January 1 in the quarterly updates to the NCCI files. The latest updates introduce 2,171 new PTP edits and 164 new MUEs.
Shelley C. Safian, PhD, RHIA, CCS-P, and Mary A. Johnson, MBA-HM-HI, CPC, review the purpose of modifiers and analyze their integral part in reporting encounters, receiving reimbursement, and promoting continuity of care.
Orthopedists perform injections and aspirations to address a range of ailments, but reporting injections can be difficult. This article reviews proper CPT coding for sacroiliac joint injections and joint arthrocentesis.
Shelley C. Safian, PhD, RHIA, CCS-P , and Mary A. Johnson, MBA-HM-HI, CPC , review the purpose of modifiers and analyze their integral part in reporting encounters, receiving reimbursement, and promoting continuity of care. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Journal of the American Medical Association (JAMA) published a study in March found that “foot and ankle care was associated with an 11% lower likelihood of death…and a 9% lower likelihood of major amputation (above or below knee).”
Julia Kyles, CPC , summarizes the advice CMS provided during a January event about reporting HCPCS add-on code G2211 for increased complexity with E/M codes.
CMS retroactively added two new CPT codes for respiratory syncytial virus (RSV) vaccine administration. The codes affect services rendered on or after October 6, 2023.
Most fracture cases originate in the ED, so orthopedic coders must understand the various scenarios that may arise based on the patient’s condition and the intent of the performing clinician.
CMS published a summary of its fourth quarter 2023 HCPCS Level II code update application decisions, including 36 additions, four revisions, and 18 deletions.
Most fracture cases originate in the ED, so orthopedic coders must understand the various scenarios that may arise based on the patient’s condition and the intent of the performing clinician. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The behavioral health coverage that CMS calls among the most important in Medicare history were finalized and expanded in the 2024 Medicare Physician Fee Schedule final rule.
Alysia Minott, CCS, CIRCC, CDIP, explains anatomic and documentation details coding professionals need to know to report cardiac and interventional radiology procedures.
For accurate CPT and ICD-10-CM coding of fractures, coders will need to identify many pieces of information, including location and type. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
This Q&A with Nancy Enos, FACMPE, CPC-I, CPMA, CEMC , covers independent historians, independent interpretations, discussion with external physicians, risk, and billing for separate E/M visits. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Julia Kyles, CPC , reviews the 2024 First Quarter National Correct Coding Initiative (NCCI) code update, which included 929 new procedure-to-procedure edit pairs.
CMS posted its 2024 Therapy Code List and Dispositions on December 28. This list indicates whether therapy services, as distinguished by HCPCS Level II and CPT codes, are recognized under CMS as “sometimes therapy” or “always therapy.”
Michael Malohifo’ou, RN, MBA, PhD , explains how excessive use of emergency departments can result in unfavorable outcomes . He also assesses the complicated relationships between EDs, social determinants of health ICD-10-CM coding, and mental and behavioral health CPT services.
A scan of healthcare news sources or the Office of Inspector General work plan often finds psychiatry and mental health practices under scrutiny. Laurie Bouzarelos, MHA, CPC, reviews revenue cycle functions, provider contracting/credentialing, and coding and documentation tips to avoid denials.
Michael Malohifo’ou, RN, MBA, PhD, explains how excessive use of emergency departments can result in unfavorable outcomes . He also assesses the complicated relationships between EDs, social determinants of health ICD-10-CM coding, and mental and behavioral health CPT services.
Q: A physician debrides a hyperkeratotic lesion on a patient’s left foot, second toe. During the same encounter, he performs a debridement of the five toenails. Which CPT codes and modifiers would be reported for this procedure?
A scan of healthcare news sources or the Office of Inspector General work plan often finds psychiatry and mental health practices under scrutiny . Laurie Bouzarelos, MHA, CPC , reviews revenue cycle functions, provider contracting/credentialing, and coding and documentation tips to avoid denials.
CMS released its January 2024 HCPCS Level II code update December 7, outlining 344 new and 74 discontinued codes. The code changes will become effective January 1, 2024.
Traversing the different rules within cardiac and interventional radiology reporting is a challenge. Alysia Minott, CCS, CIRCC, CDIP , explains anatomic and documentation details coding professionals need to know to report these procedures.
The National Correct Coding Initiative released the 2024 NCCI Policy Manual in early December, which will be effective January 1. This article covers the changes—both big and small. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient underwent a diagnostic nasal endoscopy at 10 a.m. At 7 p.m., the patient developed an epistaxis and the physician had to use some complex cauterizing techniques to control the nosebleed. How would the physician’s services in this scenario be reported?
Julia Kyles, CPC , contrasts 2024 CPT guidance and CMS’ 2024 Medicare Physician Fee Schedule (MPFS) final rule for changes to office visits, prolonged services, and split/shared services.
The National Correct Coding Initiative released the 2024 NCCI Policy Manual in early December, which will be effective January 1. This article covers the changes—both big and small.
Q: What advice can you give pertaining to clinical documentation requirements to properly report CPT codes for vaginal deliveries after cesarean (VBAC) procedures?
As important changes are coming for physician E/M reporting in 2024, coders should note the changes for reporting telemedicine services, split or shared visits, multiple visits, and hospital or observation care same day admission and discharge. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024, according to the 2024 Medicare Physician Fee Schedule final rule. The rule covers numerous operational areas for medical groups, including new coverage opportunities and billing revisions to coding and compliance updates.
For certain preventive services, coders must clarify when they become diagnostic services, which is why modifiers -GG, -PT, and -33 exist. Brush up on Medicare policies and CPT codes associated with these modifiers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The decision for an emergency clinician to report fracture or dislocation care CPT codes with an E/M code can have significant reimbursement ramifications. Hamilton Lempert, MD, FACEP, CEDC, explains the complexities of reporting this care and covers details coders should watch out for in documentation.
Niki Crawford, CCS-P, CPC, RCC, CCP-AS, CCP, QMC, describes a new addition to the Category III CPT code set with add-on code 0715T. She summarizes the procedure, reviews the associated technology, and gives coding tips and a clinical example.
Hamilton Lempert, MD, FACEP, CEDC, writes about the complexities of reporting and billing for certain ED services, as well as what coders should watch out for in documentation.
2024 CPT manuals contain several changes related to integrated peripheral and spinal neurostimulator systems. The seven code additions, four code revisions, and new guidelines clarify when coders should use permanent procedure codes from the nervous system chapter vs. a Category III code.
Q: One of our providers used a Jada device on a patient post-delivery, but I cannot find the corresponding CPT code. What is the CPT code for Jada device use?
2024 CPT manuals contain several changes related to integrated peripheral and spinal neurostimulator systems. The seven code additions, four code revisions, and new guidelines clarify when coders should use permanent procedure codes from the nervous system chapter vs. a Category III code.
Niki Crawford, CCS-P, CPC, RCC, CCP-AS, CCP, QMC , describes a new addition to the Category III CPT code set with add-on code 0715T. She summarizes the procedure, reviews the associated technology, and gives coding tips and a clinical example.
Q: Are coders required to report a social determinants of health (SDOH) ICD-10-CM code when a CPT code for an E/M service level is based on medical decision-making (MDM)?
It won’t take long to train staff on the October NCCI update, says Julia Kyles, CPC . The practitioner procedure-to-procedure edit update that went into effect October 1 deletes eight code pairs and revises 18 code pairs.
Wound care procedure reporting requires coders to follow many specific policies and procedures. This article reviews common wound care techniques of dressing changes, casting, negative pressure wound therapy, and the necessary documentation to report them in CPT. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coding staff and treating providers can increase E/M code reporting accuracy to ensure their claims hit the mark by reviewing these six Q&As. The material, created by Julia Kyles, CPC , covers medical decision making and time-based coding.
CMS' recently implemented October OPPS update brings with it a slew of new, revised, and deleted CPT and HCPCS Level II codes with effective dates ranging from April 18 to October 1. Among the additions are codes for vaccines, vaccine administration, skin substitutes, renal histotripsy, and breast imaging.
Craniosynostosis, a congenital premature fusion of cranial sutures in infants, poses a complex challenge to the child’s appearance and health. Debbie Jones, CPC, CCA , explains the condition, as well as how to report its many types in ICD-10-CM and associated surgical correction procedures in CPT.
