Category: Blog

ICD-11 Transition

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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Telehealth Reimbursement

Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts Ariel […]
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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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COVID-19 Coding and Claims Requirement

Providers Confused by COVID-19 Coding, Claim Requirements

Erratic claim volumes and confusion over COVID-19 coding and claim requirements are the top issues impacting revenue cycle operations, according to a new survey of financial leaders at US hospitals and health systems. Conducted through the Healthcare Financial Management Association’s (HFMA) Pulse Survey program, the survey commissioned by Alpha Health asked 587 chief financial officers and revenue cycle leaders […]
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2021 ICD-10-CM Codes

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 Inpatient Prospective Payment System Rule

CMS Releases Long-Awaited 2021 FY IPPS Final Rule

  Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) final rule. The […]
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CPT Code Set Simplifies EM Coding

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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2021 E/M CPT Coding Update

CPT Code for 2021

In the upcoming year, medical coders can anticipate a more streamlined process in adapting to the revised code set, which encompasses alterations in E/M codes and more. Notably, the CPT® Editorial Panel has sanctioned a smaller number of new codes for 2021, providing a welcomed respite. This is particularly relieving in light of the comprehensive […]
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