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.
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.
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?
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.
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.
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?
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.
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.
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 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.
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 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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
