Category: Medical Coding

The Need for Facility Coding Guidelines

The Need for Facility Coding Guidelines

Facility-specific coding guidelines are key to code hospital visits and encounters consistently. Another role that facility-specific guidelines play is to capture all possible reimbursement that is due to an organization. Every Oct. 1, the MS-DRGs and ICD-10-CM/PCS are updated. In addition to the MS-DRGs, the New Technology Add-On Payments (NTAPs) are updated as well. It […]
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AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

The American Medical Association updated its Current Procedural Terminology set to include updates to coding for tests that detect influenza and COVID-19. The two new codes, per the AMA’s CPT editorial panel, are: 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A […]
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Sequence ICD-10-CM Codes for Proper Payment

Key Concepts for Determining Primary Diagnosis Codes

Accurate diagnosis coding is crucial for medical billing, as it narrates the patient’s healthcare journey. Patients often present with multiple conditions, requiring coders to select and sequence the most specific codes. This sequencing, or code arrangement, is vital for correct billing. This discussion highlights five key terms from the ICD-10-CM Official Guidelines for Coding and […]
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ICD-10 Coding Tips for Influenza

ICD-10 Coding Tips for Influenza

There has been much discussion about COVID-19 this year, but as autumn approaches, thoughts turn towards influenza season. The Advisory Committee on Immunization Policies (ACIP) recently published guidelines for flu vaccination. Their advice is that routine annual vaccination is recommended for everyone 6 months of age and older. The United States vaccines will include updates […]
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New Medical Coding Rules for E M Visits

New Medical Coding Rules for E M Visits

Q: Do the new 2021 coding rules for office visits apply to all payers or just Medicare and Medicaid? Also, are these rules just for office visits, or can we use them for hospital visits, nursing home services, and home visits? A: The changes to the documentation requirements are for codes 99202-99215 only and are […]
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Rules Are Changing_ The Impending Transition to ICD-11

Rules Are Changing: The Impending Transition to ICD-11

The World Health Organization (WHO) updates ICD codes every 10 years to improve clinical use and acknowledge innovations in healthcare. After the tumultuous transition to the 10th revision of the International Classification of Diseases, simply mentioning the phrase “ICD-11” is liable to strike fear in the hearts of revenue cycle professionals and healthcare providers across […]
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AMA Approves 2 New CPT Codes for COVID-19

AMA Approves 2 New CPT Codes for COVID-19

One of the codes, CPT Code 99072, is for reporting additional supplies used to mitigate spread of the virus. The American Medical Association (AMA) announced, Sept. 8, two new Category I CPT® codes to meet the changing needs of the healthcare industry brought about by the COVID-19 public health emergency (PHE). The codes were approved […]
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See What’s New for ICD-10-CM

See What’s New for ICD-10-CM

Make sure your diagnosis coding is up to date by reviewing this chapter-by-chapter summary of the changes effective October 1. The future is here, and it brought diagnosis codes for hoverboard accidents. But that’s not all that’s changed in ICD-10-CM 2021, effective Oct. 1, 2020, through Sept. 30, 2021. Below are highlights from the 56-page […]
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2021 CPT Code Set Simplifies E_M Coding, Adds COVID-19 Tests

2021 CPT Code Set Simplifies E/M Coding, Adds COVID-19 Tests

  The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services. The code set released earlier today modified E/M office visit codes 99201 through 99215 to eliminate history and physical exam as […]
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