In a recent National Correct Coding Initiative (NCCI) update, CMS rolled back many of the procedural edits that it temporarily extended in light of the novel coronavirus public health emergency. Read up on the changes, including 291,274 procedure-to-procedure edits, which took effect October 1.
Outpatient coding for behavioral health services can be tricky given number of conditions that influence mental wellbeing. Review potentially confusing CPT coding guidelines for psychiatric evaluations, E/M visit services, and 2021 updates to ICD-10-CM codes for behavioral health. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
On January 1, new patient office visit code 99201 will be deleted from the CPT code set and coders will find revised descriptors for E/M codes 99202-99205 and 99211-99215. Read about how these changes will impact E/M leveling, medical decision-making (MDM), and code selection for outpatient visits.
Baylor Scott & White-College Station didn't properly bill Medicare for supplemental outlier payments, according to a September Office of Inspector General (OIG) report. Reviewed claims contained errors due to overcharging and inaccurate coding, resulting in $189,276 in overpayments, said the report.
Between 50-80% of pregnant women complain of back pain, according to the American College of Obstetricians and Gynecologists. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC , writes about ICD-10-CM documentation and coding for back pain during pregnancy.
A patient with a history of hypertension sees a cardiologist for chest discomfort during exercise. The cardiologist completes an office visit and performs a cardiac stress test the same day. Would it be appropriate to report the visit using an E/M code with modifier -25?
Review significant updates to the musculoskeletal chapter of the ICD-10-CM manual including 57 new codes and updated guidelines for reporting arthritis, temporomandibular joint disorders, osteoporosis, and osteochondrosis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Strabismus is one of the most common eye problems in children, according to Stanford Children’s Health. In this article, Debbie Jones, CPC, CCA , details ICD-10-CM coding for strabismus and CPT coding for surgical treatments used to correct eye misalignment.
CMS continues to focus on site-neutral payment policies and keeping payments down for 340B-acquired drugs in the 2021 OPPS proposed rule, released in early August. Read about these proposals which if finalized, will impact hospital billing and payment starting January 1.
Q: During an outpatient visit, a nurse reviews the patient’s medical history and a physician performs an examination in the presence of the nurse. If you adhere to the 2021 E/M guidelines and use time as the controlling factor for code selection, can you report one E/M code for these shared services?
The American Medical Association (AMA) on September 8 published two new CPT codes for novel coronavirus (COVID-19)-related services, including one that accounts for additional supplies and clinical staff time used to mitigate the spread of the virus.
The fiscal year (FY) 2021 update to the ICD-10-CM code set includes 26 new codes for nervous system conditions such as cerebellar ataxia and Dravet syndrome. Review these new codes and associated updates to the ICD-10-CM guidelines set to go into effect October 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: When would it be appropriate to report modifier -58 (staged or related procedure or service by the same physician during the postoperative period) for a procedure performed during the postoperative period?
Outpatient coders should be familiar with CPT reporting for knee surgeries based on information in the operative note. This article reviews the anatomy of the knee joint and CPT coding for arthroscopic and reconstructive procedures used to visualize and treat common knee conditions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The final 2021 CPT, ICD-10-CM, and ICD-10-PCS code sets were released last week, introducing new, revised, and deleted codes for diagnostic and procedural services and accompanying guideline changes. Read up on the changes, which will impact payment for hospital services in 2021.