Category: Medical Coding

Demystifying Facility Coding

Demystifying Facility Coding

Modifiers 52: Professional fee-for-service guidelines for modifiers do not apply in the clinical setting. Reduced, Failed, Aborted, Aborted… which one? What are the requirements for using modifiers 52, 73 and 74? These questions are common in the coding center world, and  the answers  never seem to be clear. Confusingly mix up the medical code instructions […]
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HCPCS Level II Code Updates for April 2024

HCPCS Level II Code Updates for April 2024

The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website.  April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some  code […]
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AMA Aims to Streamline Prior Authorization Billing with New Codes

AMA Aims to Streamline Prior Authorization Billing with New Codes

New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
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Navigating Regulatory Compliance in Medical Coding for Accurate Billing

Navigating Regulatory Compliance in Medical Coding for Accurate Billing

Explore the intricacies of codes for a better understanding of regulatory compliance in medical coding. Healthcare billing and documentation are based on medical coding. An accurate representation of the patient’s health journey, appropriate reimbursements, and avoiding potential legal pitfalls are crucial to ensuring accurate representation of the patient’s health journey, not just an administrative formality. […]
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Differences: Preventive vs. Office Visits in Medical Coding & Billing

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
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Top Medical Coding Challenges and How to Avoid Them

Top Medical Coding Challenges and How to Avoid Them

Medical coding challenges: Medical coding in healthcare is the process of converting complicated medical information into standardized codes that may be used for Medical billing and record keeping. Medical coding presents unique obstacles, even though it is critical for guaranteeing proper compensation and keeping a complete patient history. In this article, we’ll navigate through common […]
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Key Changes In CY 2024 MPFS Final Rule: New E/M Code, Telehealth Updates, And More

Key Changes In CY 2024 MPFS Final Rule: New E/M Code, Telehealth Updates, And More

The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]
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Coding Changes Impacting

CPT 2024 Coding Changes Impacting General Surgery and Specialties

The American Medical Association (AMA) Current Procedural Phrasing (CPT)* code set is overhauled every year. This year, numerous of the upgrades are time-based codes, which may influence when they may be detailed. This article depicts CPT 2024 Coding Updates that are pertinent to common surgery and related specialties. Hyperthermic Intraperitoneal Chemotherapy in CPT 2024 Coding […]
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Navigating E&M Code Changes

Navigating E&M Code Changes

It is expected that the Centers for Medicare & Medicaid Services (CMS) will release a completely revamped version of the evaluation and management (E&M) codes by 2021, particularly for the office visit codes (999201-99205 and 99211-99215). In addition to the changes to the office visit codes, there were significant changes to the 2023 guidelines. These […]
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