Federal approval of the Pfizer vaccine, believed to be better than 90 percent effective, could occur before the end of the month. When the long-awaited and much-anticipated COVID-19 vaccine becomes available in the U.S., a development that could take place before the end of the year, a set of new Current Procedural Terminology (CPT®) codes […]
You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
How many times has a provider asked you, “What do I need to document to get a 99215?” All too often, medical coders feel they should help their providers understand what elements of documentation are needed to warrant the higher level evaluation and management (E/M) service. Do not do it! If It Isn’t Documented, It […]
Multiple Surgeries Multiple surgeries are separate procedures performed by a physician on the same patient at the same operative session or on the same day. Multiple surgeries are distinguished from procedures that are components of or incidental to a primary procedure. Intraoperative services, incidental surgeries or components of surgeries will not be separately reimbursed. Reimbursement […]
Novitas Solutions recently issued a Modifier 50 Fact Sheet, reminding medical coders of the proper use for this CPT payment modifier. The Medicare Administrative Contractor (MAC) for jurisdictions H and L warns that, effective for Part B claims received on and after Aug. 16, 2019, services will be rejected as unprocessable when modifier 50 Bilateral procedure is used […]
“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during the same encounter? Did you consult […]