The American Medical Association recently announced new codes, deletions, and revisions included in the 2025 CPT code set. Explore these notable updates to the code set.
Q: Based on the instructions for sacroiliac joint injections, our physicians believe they can bill the injection and report imaging separately if they use ultrasound. Is this true?
How do you code the conversion of a previous unicompartment knee arthroplasty to a total knee arthroplasty when there is no conversion code? This article reviews the AMA’s and the American Academy of Orthopaedic Surgeons’ takes on this issue. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Revisions to the E/M guidelines have simplified documentation and eliminated unnecessary documentation. Clinicians may choose levels of E/M services based on time or level of medical decision-making. Nancy M. Enos, FACMPE, CPC-I, CPMA, CEMC, CPC emeritus , dives deep into both processes and provides best practices for each.
The American Medical Association recently announced new codes, deletions, and revisions included in the CPT 2025 code set. Explore these notable updates to the code set.
The connection between medical necessity and diagnosis coding should be included with your training on the 2025 update to the ICD-10-CM code set. This article serves as a refresher on medical necessity, possible ICD-10-CM conflicts, and other best practices.
When an office/outpatient visit is coded based on time, think beyond face-to-face time to get full credit. This article reviews time-based coding, how to count time, which activities count toward time, and which ones don’t. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Critical access hospitals ensure that people living in remote, rural, or underserved communities still have access to medical care. Learn about the ins and outs of their reimbursement models and other billing and coding considerations.
According to a recent analysis, healthcare organizations are submitting more prior authorization requests to Medicare Advantage plans and more of those requests are being denied. Review the analysis’ findings to be more aware of prior authorization processes and CMS’ efforts to streamline them.
Q: How do I know when to use CPT code 26370 vs. 26356, for a finger tendon repair? Is it based on whether there is an intact flexor digitorum superficialis (FDS) tendon, or whether the cut or laceration of the flexor digitorum profundus (FDP) tendon was in Zone II?
Q: What ICD-10-CM code should we report for a periprosthetic fracture due to an injury? Do you use the S codes for a traumatic fracture with a secondary code for replacement, or do you select a code from the M97 (Periprosthetic fracture around internal prosthetic joint) category?
Being able to differentiate between the types of colonoscopy procedures in outpatient settings is essential to ensure that the correct codes are documented. This article reviews the main types of colonoscopies and the factors that determine how they are coded. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A recent draft local coverage determination includes detailed coverage requirements for chronic migraine treatment. This article reviews the terminology that drives migraine coding.
Patients who self-reported housing instability often didn’t have the correct ICD-10-CM codes documented in their record, according to a recent study. Review the results of the study and be more aware of the importance of properly documenting housing insecurity to ensure appropriate housing and medical services are delivered.
The ICD-10-CM changes for fiscal year 2025 are coming October 1, 2024. Learn about some of the changes to guidelines, notes, wording in current categories, and expansion of code categories.
With CMS’ release of its proposed 2025 Medicare physician fee schedule, the agency proposed many policy changes and revisions. Explore several of them and other announcements made by CMS.
Gain unique and fresh insights from clinical documentation integrity professionals in unique settings to help you strengthen your organization’s denials management efforts.
Stand-alone and integrated physician practices have unique challenges and requirements regarding revenue cycle management. Discover how revenue integrity programs in professional fee settings are designed and function.
CMS’ proposed rule to revise the Medicare hospital Outpatient Prospective Payment System for calendar year 2025 has been released. Review some of the proposals that could directly impact your organization.
Q: What are some of the common documentation pitfalls or missteps related to pediatric malnutrition? And what can CDI specialists do to address them proactively?