The American Medical Association (AMA) has created three new CPT® codes to report the administration of the Moderna COVID-19 vaccine for patients 6 through 11 years. The new codes are effective June 17, 2022. Note These New Moderna Admin Codes For children ages 6 through 11 years, report the Moderna vaccine with existing CPT® code […]
The effective date for 0081A-0083A and 91308 is June 17, 2022. The Food and Drug Administration (FDA) granted emergency use authorization (EUA) to the Pfizer-BioNTech COVID-19 vaccine for patients ages 6 months to 4 years. The new CPT® codes for reporting this vaccine are: 0081A Immunization administration by intramuscular injection of severe acute respiratory syndrome […]
Medicare updates its policy for these services to align with CPT®. The Centers for Medicare & Medicaid Services (CMS) revised its Part B benefit policy for critical care services, effective Jan. 1, 2022. Policy changes finalized in the 2022 Medicare Physician Fee Schedule (MPFS) final rule include a new definition of critical care services, who […]
Implement a compliance process in your practice for querying providers for outpatient services. Querying providers about their documentation may seem inappropriate, but it is an important part of the medical coding process. A physician query allows a medical coder to formally ask a healthcare provider a question about something they wrote (or didn’t write) in […]
How to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is normally addressed during an AWV. How to avoid it:“I often tell doctors to […]
Opponents of the loosened interstate telehealth restrictions that were instituted at the start of the COVID-19 pandemic argued that it would result in out-of-state doctors luring patients away from their current physicians. But a new study finds that most out-of-state telehealth is used for continuity of care, not acquiring new patients. The study compares interstate […]
Exactly 1,468 new diagnosis codes will be added to the ICD-10-CM code set for fiscal year (FY) 2023. Moreover, 251 codes will be deleted, 35 code descriptors will be revised, and 36 codes will be converted to parent codes. The changes go into effect Oct. 1. Review the Latest Files The diagnosis code files and […]
It’s important to be realistic about what AI can and can’t do currently. Artificial intelligence (AI) has been a buzzword in payment integrity for years. Companies are increasingly using AI and data mining to identify healthcare savings. This technology can be helpful in the right scenarios. Data versus Nuance AI, which includes technologies like machine […]
Question: Can you please tell us what the new codes are for principal care management and chronic care management? Answer: There are three new codes in the care management section of the CPT codebook. Care Management Services Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” […]
Providers today are stuck using outdated templates, leaving ample room for improvement. Let’s take a retrospective look at evaluation and management (E&M) services—examining what we had, what we have now, and what lies ahead. Before the implementation of the 2021 documentation guideline (DG) changes, many providers relied on templates built around outdated office-based documentation requirements […]