Laura Evans, CPC , and Julia Kyles, CPC , break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient receives Apligraf® (44 sq. cm) after subcutaneous wound debridement. Ten sq. cm is applied to a diabetic foot ulcer on the patient’s left heel and 20 sq. cm to an ulcer on the patient’s right ankle. What CPT codes would the facility use to report these services?
Q: A patient is diagnosed with Type 2 diabetes mellitus and arteriosclerotic peripheral artery disease (PAD). Can we report ICD-10-CM code E11.51 with a code from subcategory I70.2- to describe affected vessels?
CMS recently added 24 audiology and speech-language pathology services to its list of telehealth services covered under Medicare during the COVID-19 public health emergency (PHE). These services include speech, hearing, and swallowing assessments, and cognitive interventions.
Effective management of claim edits and denials is a cornerstone of a sound revenue cycle. See how your organization compares to others and what you can do to improve.
Viral hemorrhagic fevers (VHF) are infectious diseases that pose a great public health risk due to their epidemic potential. Debbie Jones, CPC, CCA , breaks down ICD-10-CM coding for four VHFs: Crimean-Congo hemorrhagic fever, Ebola virus disease, Lassa fever, and Marburg virus disease. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Essential newborn care includes services provided at the time of birth and over the first hours of life. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about E/M coding for these routine obstetric services.
Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2x4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)?
Physician and non-physician practitioners may benefit from reviewing documentation requirements and HCPCS Level II codes for knee orthoses, according to a recent Medicare Quarterly Compliance Newsletter .
Corneal dystrophies are a group of genetic, often progressive, eye disorders that alter functioning of the cornea. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , breaks down ICD-10-CM coding for corneal dystrophies and CPT coding for procedures used to treat them.
Approximately 34.2 million Americans, or 10.5% of the U.S. population, were diagnosed with diabetes in 2018, according to the Centers for Disease Control and Prevention. Review signs and symptoms of diabetes mellitus types 1 and 2 and ICD-10-CM coding for these conditions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare auditors have identified failure to document time as a key flaw in claims for advance care planning (ACP), and the Office of Inspector General plans to conduct an audit of these services. Read up on documentation requirements and CPT coding for ACP to prevent claim denials.
The mid-revenue cycle is rife with possibilities to lose earned, appropriate revenue. Learn how to identify common weaknesses and deploy coding and technology to avoid revenue loss.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, CCDS-O , analyzes complex E/M coding guidance for selecting an outpatient visit level on the basis of medical decision-making (MDM).
Refresh your knowledge of dysphagia, esophagitis, gastroesophageal reflux disease, and Barrett’s esophagus, and review guidance for reporting these conditions in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Medical Association’s (AMA) CPT Editorial Panel at its February meeting approved technical corrections to the E/M coding guidelines for outpatient visits. The corrections were uploaded to the AMA website on March 9 and go into effect retroactively from January 1.
CMS recently added six codes to the list of services that may be reported with HCPCS modifier -CS (cost-sharing), which requires Medicare to cover beneficiary cost-sharing during office visits and other encounters for the duration of the COVID-19 public health emergency.
Supporting accurate Hierarchical Condition Category (HCC) capture is essential to success under the growing number of risk-adjusted payment models. With their strong knowledge of coding and documentation guidelines and insight into emerging trends, coders are a key part of that strategy.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, CCDS-O, analyzes confusing E/M guidelines for time-based visits and prolonged services provided before or after a face-to face encounter.
Coding for traumatic fractures is based on details about the broken bone and the event that caused the injury. Review ICD-10-CM codes and guidelines for reporting different types of traumatic fractures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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.
Arthroscopic surgical procedures involve the insertion of a small scope into the interior of a joint, allowing the physician to view the joint without making a large incision through the skin. Review CPT coding for arthroscopic procedures of the hip and knee joints. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A vaginal cuff tear, also known as vaginal cuff dehiscence, is a severe complication of a hysterectomy . Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes about CPT coding for transvaginal and laparoscopic vaginal cuff repairs.
The Food and Drug Administration (FDA) recently issued an emergency use authorization (EUA) for the combination treatment of bamlanivimab and etesevimab for COVID-19 patients at high risk for severe infection.
In its February MLN Connects newsletter, CMS reminds providers that HCPCS add-on code G2211 for visit complexity is a bundled service under the Medicare Physician Fee Schedule, meaning the application of this code will not result in additional payment for a billed E/M visit service.
Podiatrists are doctors devoted to the health and wellbeing of the feet, ankles, and lower extremities. Review common ICD-10-CM and CPT codes reported by podiatrists in facility settings.
CPT® neurology codes describe advanced techniques to evaluate and treat conditions of the brain, spinal cord, and nerves. This article details CPT coding for three procedural services used to assess neurological symptoms: electroencephalogram, electromyography, and auditory-evoked potentials testing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A recent analysis of electronic health record data from 2015 to 2019 shows that providers underreported ICD-10-CM codes in categories Z55-Z65 for social determinants of health.
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.
Bartholin’s gland cysts or abscesses develop in approximately 2% of women, according to the American Academy of Family Physicians. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about CPT and ICD-10-CM coding for the diagnosis and treatment of Bartholin’s gland cysts.
Review coronary anatomy and CPT coding for aortic and iliac repairs, as well as selective procedures used to treat vascular occlusions in the lower extremities. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The January 2021 quarterly update to the OPPS , released by CMS December 31, announces new HCPCS codes for vitrectomy, nasal endoscopy, and intravascular lithotripsy procedures. The update also...
In the 2021 Medicare Physician Fee Schedule final rule, CMS announced new HCPCS add-on code G2211 for visit complexity inherent to E/M services. Julia Kyles, CPC, describes when and how to report G2211 with E/M codes 99202-99215.
Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I, HCISPP , writes about CPT coding for total hip arthroplasty and autologous chondrocyte implantation: two orthopedic procedures that were recently removed from the inpatient-only (IPO) list for 2021.
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. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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%.
Audit defense is a key strategy in protecting earned revenue and ensuring coding and billing compliance. Read about auditing trends during the COVID-19 public health emergency and internal processes that organizations are using to track audit activity.
The Medicine chapter of the CPT Manual covers a wide variety of services applicable to multiple specialties. Review calendar year 2021 updates to CPT® codes for medicine services including new codes for continuous electrocardiogram recordings and auditory-evoked potentials. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: When might it be appropriate to report computer-aided mapping of the cervix uteri using 2021 CPT add-on code 57465 (computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect)?
