Category: Medical Coding

New COVID-19-Related ICD-10-CM Codes Take Effect

New COVID-19-Related ICD-10-CM Codes Take Effect

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) broke from the usual release schedule and implemented the following six new codes related to COVID-19 on Jan. 1 and issued accompanying guidelines. Z20.822 Contact with and (suspected) exposure to COVID-19 For asymptomatic individuals with actual or suspected exposure to COVID-19, assign code Z20.822. For symptomatic […]

Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
Top Error Rates Offer Clues to Denials

Top Error Rates Offer Clues to Denials

The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
6 Questions Ensure E_M Compliance

6 Questions Ensure E/M Compliance

Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
CPT 2021 Update_ New Lab, Category III Codes

CPT® 2021 Code Updates: Second and Third Quarters

The American Medical Association (AMA) has released updates for the second and third quarters of CPT® 2021. These changes, including new, revised, and deleted codes, will be implemented in AAPC’s Codify system as they become effective. Practices should also update their CPT® 2021 code books and electronic health record (EHR) software accordingly. Proprietary Laboratory Analyses […]
A Glance at 2021 Evaluation and Management Changes

A Glance at 2021 Evaluation and Management Changes

The evaluation and management (E/M) changes for calendar year 2021 are the result of a collaborative effort between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). CMS first addressed the changes in the 2020 Medicare Physician Fee Schedule Final Rule, in which CMS indicated that it planned on adopting […]
AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine

AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine

In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine. AMA assigned Category 1 CPT code 91302 to the vaccine manufactured by the Cambridge, United Kingdom (UK) company, as well as vaccine administration CPT codes […]
CMS Releases HCPCS Codes For Covid-19 Antibody Drug

CMS Releases HCPCS Codes For Covid-19 Antibody Drug

  A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]