CMS recently released an update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edit files, introducing more than 4,000 new CPT code pairs. The PTP edits took effect April 1 and primarily involve codes found in the pathology and laboratory section of the CPT Manual .
Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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.
Bruxism, or excessive teeth grinding, is a common condition that is often brought on by stress and anxiety . Debbie Jones, CPC, CCA , describes the causes and symptoms of bruxism and ICD-10-CM coding for the condition.
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.
Following the release of the Medicare Payment Advisory Commission’s March report to Congress, the American Medical Association (AMA) urged Congress to revise the Medicare Physician Fee Schedule (MPFS) to include stable, annual payment updates that keep up with inflation and practice costs.
Anxiety disorders are the most common mental illness in the U.S., according to the National Institute of Mental Health Statistics. Shelley Safian, PhD, RHIA, CCS-P, COC, CIC , breaks down ICD-10-CM coding for common types of anxiety disorders and psychotherapy treatments used to manage them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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.
CMS recently released new HCPCS modifiers -FR, -FQ, -FS, and -FT for telehealth visits. Julia Kyles, CPC , breaks down reporting guidance for these new physician modifiers that took effect January 1.
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.
CMS recently announced a new HCPCS Level II code for COVID-19 convalescent plasma administered in the outpatient setting, effective for claims submitted on or after December 28, 2021.
The 2022 ICD-10-CM manual includes new codes for thrombotic microangiopathy (TMA)—a rare clinical syndrome defined by the presence of hemolytic anemia, organ dysfunction, and low platelets. Read up on TMA pathophysiology and diagnosis coding.
Q: What is the difference between anterior and posterior approaches to spinal surgery, and when might a physician use a combined (anterior and posterior) approach?
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.
Chapter 19 of ICD-10-CM includes codes for various types of injuries, poisonings, and other consequences of external causes. Review integumentary anatomy and ICD-10-CM coding for burns and superficial injuries. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Medical Association (AMA) recently announced three new CPT codes for administration of Pfizer’s COVID-19 vaccine in children 6 months to under 5 years old.
