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?
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.
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.
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?
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.
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.
Erectile dysfunction, sometimes called impotence, is a common male disorder. Debbie Jones, CPC, CCA covers physiology, symptoms, and treatment for erectile dysfunction, as well as associated ICD-10-CM and CPT codes.
Coding professionals can get an early start to 2023 by reviewing CPT codes that will be added, revised, and deleted next year. Analysis of the 2023 Medicare Physician Fee Schedule proposed rule reveals changes to 10 chapters in the CPT Manual , in addition to the revisions to the E/M chapter.
Arthroscopic procedures have been the topic of controversy and confusion in the coding community. This article covers relevant anatomy, common shoulder arthroscopy and arthroplasty procedures, and National Correct Coding Initiative edits to keep in mind. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coding professionals can get an early start to 2023 by reviewing CPT codes that will be added, revised, and deleted next year. Analysis of the proposed 2023 Medicare Physician Fee Schedule reveals changes to 10 chapters in the CPT Manual , in addition to the revisions to the E/M chapter.
The American Medical Association (AMA) released the Category I vaccine product codes for monkeypox tests and vaccines. The organization made them effective immediately upon their approval by the CPT Editorial Panel on July 26. The new codes are scheduled to appear in the in the 2024 CPT Manual.
In part two of this series, expert Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC, addresses the “nuts and bolts” of ICD-10-CM coding for anesthesia services, including how and when to append modifiers.
Interventional radiology describes a set of procedures that involve the insertion of medical devices and instruments to diagnose or treat disorders of blood vessels. This article covers common revascularization procedures, CPT codes associated with each vascular territory, and potential coding errors. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A broken nose is a break in the bone or cartilage over the bridge of the nose or over the septum—the structure that separates the nostrils. Debbie Jones, CPC, CCA , explains how to select the most specific CPT codes for nasal fracture and dislocation treatments.
Because of the prevalence of eating disorders, coders should become familiar with their types, symptoms, codes, and relevant guidelines. They appear in ICD-10-CM under category F50 (eating disorders), but codes for individual symptoms appear throughout the manual.
Because of the prevalence of eating disorders, coders should become familiar with their types, symptoms, codes, and relevant guidelines. They appear in ICD-10-CM under category F50 (eating disorders), but codes for individual symptoms appear throughout the manual. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS proposes to adapt the 2023 AMA CPT guideline changes to the nursing facility (NF) codes into its Medicare policy structure next year, according to the 2023 Medicare Physician Fee Schedule proposed rule.
Most coders never have the opportunity to code for anesthesia. Expert Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains that ICD-10-CM coding for anesthesia services is interesting and straightforward, but can be confusing if an individual is unfamiliar with coding guidelines and terminology for anesthesia administration.
A broken nose is a break in the bone or cartilage over the bridge of the nose or over the septum—the structure that separates the nostrils. Debbie Jones, CPC, CCA , explains how to select the most specific CPT codes for nasal fracture and dislocation treatments.
Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-19-related billing flexibilities, and value-based care, according to the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule released July 7.
The 2023 CPT update will shift provider consults, facility, and home-based E/M visits to a coding model based on medical decision-making (MDM) or time, according to the AMA.
Q: Based on National Correct Coding Initiative Manual guidelines, CMS allows facilities to bill 1 unit of CPT code 94640 per episode of care regardless of the number of treatments provided. Should you bill 1 unit of CPT code 94640 even if the service was performed three times?
Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. Refresh your knowledge of this modifier with coding tips and example scenarios.
The National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services is used to control improper coding leading to inappropriate payment for Part B services. This article provides an in-depth overview of 2022 updates to the NCCI Manual including new and revised reporting guidance. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Hospital coding for wound procedures is notoriously difficult, as the process can seem as messy as the injuries themselves. Clarify wound documentation and guidance for reporting wound diagnoses and procedures using ICD-10-CM, CPT, and HCPCS Level II codes.
Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. Refresh your knowledge of this modifier with coding tips and example scenarios.
Hospital coding for wound procedures is notoriously difficult, as the process can seem as messy as the injuries themselves. Clarify wound documentation and guidance for reporting wound diagnoses and procedures using ICD-10-CM, CPT, and HCPCS Level II codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medication Therapy Management (MTM) is a group of services provided by pharmacists that involve active management of drug therapy. Review CPT coding, the role of pharmacists, and documentation tips associated with MTM.
Podiatry is the study, diagnosis, and treatment of disorders or deformities of the foot and ankle. Read up on foot and ankle anatomy and CPT coding for hallux valgus and rigidus corrections, cock-up fifth toe repairs, toe amputations, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sometimes even the most seasoned revenue integrity professionals get stumped trying to navigate the maze of billing, charging, and coding rules that govern chargemaster structure. Review expert answers to perplexing chargemaster questions.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the difference between an implant and a foreign body removal and outlines CPT coding for these procedures.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the difference between an implant and a foreign body removal and outlines CPT coding for these procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Physician service modifier -FT for unrelated E/M visits provided on the same day has been a source of confusion for many coding and billing professionals. Review the latest coding and billing guidance for reporting this modifier.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Providers can now code for E/M visits based solely on medical decision-making. Julia Kyles, CPC , outlines how to use the first column of the medical decision-making chart in the CPT Manual to determine E/M level selection.
Arterial embolization is less invasive than open surgery and is often performed as an outpatient procedure in a hospital setting. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, evaluates medical necessity and CPT coding for uterine artery embolization.
To assign the most specific CPT codes for spinal procedures, coders need a solid understanding of spinal anatomy and surgical terminology. Review spinal anatomy and CPT coding for vertebral corpectomies, discectomies, laminectomies, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Under certain circumstances, a service or procedure may be partially reduced or eliminated at the discretion of the physician. Read up on the correct application of hospital modifiers -52, -73, and -74 for reduced and discontinued procedural services.
Under certain circumstances, a service or procedure may be partially reduced or eliminated at the discretion of the physician. Read up on the correct application of hospital modifiers -52, -73, and -74 for reduced and discontinued procedural services.
State and federal prosecutors continue to extract sizable settlements from practices that allegedly submitted fraudulent claims for one type of service—urine drug tests (UDT). In this article, Julia Kyles, CPC , breaks down fraudulent coding and billing patterns for UDT services.
Review new CPT codes 98975-98981 for the monitoring of non-physiologic patient data such as musculoskeletal system status, respiratory system status, and medication adherence.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for subsequent hospital visits and services provided on the day of discharge from inpatient status.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes that it’s not unusual for an outpatient coder to advance their career by diving into inpatient coding. When deciding to learn about ICD-10-PCS, it’s important to first understand the basics and compare and contrast ICD-10-PCS and CPT. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Review documentation requirements and CPT coding for radiology services including computed tomography and x-ray scans, breast mammography, and bone length studies.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for subsequent hospital visits and services provided on the day of discharge from inpatient status.
Review documentation requirements and CPT coding for radiology services including computed tomography and x-ray scans, breast mammography, and bone length studies. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
