Category: Medical Coding

Q4 HCPCS Level II code

Q4 2024 HCPCS Level II code Update: new Codes, Descriptor Changes, more

The Centers for Medicare & Medicaid Services (CMS) has announced updates to the Q4 HCPCS Level II code, effective October 1, 2024. These changes include: 58 new codes 10 codes with updated descriptions 6 discontinued codes Key Changes: New codes for medical and surgical supplies, outpatient procedures, durable medical equipment, and orthotic procedures. Replacement code […]
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CDI and coding

Overcoming CDI and Coding Challenges: The Power of AI-Driven Solutions

Defining the Challenge: Overcoming Obstacles in CDI and Coding: To clarify the overwhelming claims made by technology vendors, I’ve provided some basic definitions. As we embark on this journey, it’s crucial to pinpoint the specific obstacles we face. This will help us demonstrate to senior leadership and stakeholders the need for AI-driven solutions to enhance […]
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Reimbursement-methodology

Understanding Medical Codes and Reimbursement Methodologies

The Role of Medical Codes in Reimbursement Methodologies: Medical codes, such as CPT, HCPCS, and ICD-10 (CM and PCS), are essential components of various reimbursement methodologies. The Inpatient Prospective Payment System (IPPS), used by Medicare fee-for-service, categorizes patient stays into Medicare Severity Diagnosis Related Groups (MS-DRGs) based on ICD-10 codes processed through a computerized system. […]
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H5N8 Avian Influenza Vaccine

New CPT Codes Streamline Vaccination for H5N8 Avian Influenza

H5N8 Avian Influenza Vaccine: The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include new codes for vaccines protecting against the H5N8 strain of avian influenza. This update follows a recent global outbreak of avian influenza, particularly the H5N1 strain, which has affected wild birds, poultry, dairy cows, and […]
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Billing Codes for MRI

2025 Billing Codes Proposed for Complex MRIs with Implants

CMS is proposing new Billing Codes for MRI in the draft 2025 Medicare Physician Fee Schedule to account for the extra work involved in safely performing MRIs on patients with implants or other factors that could pose risks. These additional tasks might involve reviewing a patient’s medical history, researching implant specifics, carefully considering risks and […]
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CPT Codes

The Three Categories of CPT Codes

Current procedural terminology meaning: Current Procedural Terminology or CPT codes are developed by the American Medical Association (AMA) to describe a wide range of healthcare services provided by physicians, hospitals, and other healthcare professionals. These codes are utilized to communicate with other physicians, hospitals, and insurers for claims processing. There are three categories of CPT Codes: […]
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