Category: Medical Coding

COVID-19 Coding_ Guidance On 11 Scenarios

COVID-19 Coding: AMA Provides Guidance On 11 Scenarios

The American Medical Association has published a COVID-19 coding scenario guide that includes a number of coding scenarios for physicians treating COVID-19 patients. The COVID-19 scenarios presented include: Patient comes to office for E/M visit, is tested for COVID-19 during the visit. Patient comes to office for E/M visit re: COVID-19 and is directed to […]
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COVID 19 Has New Code

COVID 19 Has New Code in April

  Coordination and Maintenance committee meeting announces COVID 19 code effective April 1, 2020. The Coordination and Maintenance Committee Meeting announced that the COVID-19 code that was originally scheduled to become effective October 1, 2020 will now be effective April 1, 2020. The code that will be effective is U07.1.  The effective date was changed […]
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Medical Code Change for Influenza Season

Code Change for Influenza Season 2020-2021

The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza season. Let’s start with a new CPT® code for the flu vaccine. Flu Activity Report The Centers for Disease Control and Prevention (CDC) reports that viral activity is decreasing in the United States. According to […]
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Billing and Coding for Coronavirus_ 7 things to know

Billing and Coding for Coronavirus: 7 things to know

CMS has released several fact sheets in recent weeks on billing and coding to provide guidance to healthcare organizations testing and treating patients for COVID-19, the disease caused by the novel coronavirus. Seven things to know: CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s […]
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MIPS Changes

What You Need to Know About 2020 MIPS Changes

In November 2019, CMS published the 2020 Quality Payment Program Final Rule (the “2020 MIPS Final Rule Changes”). Below is a summary of some of the most notable changes to the Merit-Based Incentive Payment Program (MIPS). For a complete list of changes, please review the 2020 MIPS Final Rule or CMS’ Quality Payment Program Resource […]
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E_M Coding Guidelines Could Ease Physicians’ Documentation Burdens

How 2021 E/M Coding Guidelines Could Ease Physicians’ Documentation Burdens

Physicians will potentially have a lighter documentation burden and more time to spend with patients in 2021 thanks to an overhaul of Medicare Coding guidelines for outpatient evaluation and management (E/M) services. “The whole point was to have people not document stuff that was not necessary, not relevant to the clinical management of the patient,” […]
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FESS Codes Claims for Improper Payment Adjustments

Check Your FESS Codes Claims for Improper Payment Adjustments

MACs may be applying the multiple endoscopy rules incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple endoscopic procedures to the family of functional endoscopic sinus surgery (FESS) codes. Practices are now getting remittance advice […]
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