Category: Medical Coding

HCPCS codes G9037 and G9038

New MCP Model HCPCS Codes G9037 & G9038

Clinicians participating in the Making Care Primary (MCP) model now have access to two new HCPCS Level II codes, HCPCS Codes G9037 and G9038, introduced in fiscal year (FY) 2024. These codes expand the scope of interprofessional consultation services, allowing primary care providers (PCPs) to bill for time spent collaborating with specialists. The MCP Model: […]
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AI in Medical Coding

AI in Medical Coding: A New Era of Accuracy and Efficiency

Medical coding is the lifeblood of healthcare operations. It forms the crucial bridge between patient care and financial reimbursement, ensuring that healthcare providers are compensated for the services they render. However, the complexity and sheer volume of medical codes, coupled with the ever-evolving regulatory landscape, make accuracy a persistent challenge. This is where the potential […]
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CAR-T therapy coding

A Deep Dive into CAR-T Therapy Coding and Billing for Medicare

Stay updated with the latest guidelines for reporting products and procedures related to Chimeric Antigen Receptor (CAR) T-cell therapy to ensure accurate CAR-T therapy coding and billing for Medicare patients. Overview of CAR-T Therapy CAR-T is a cutting-edge cell-based gene therapy that modifies a patient’s own T lymphocytes (T-cells) in a lab to express chimeric […]
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claim denials with chiropractic

Preventing Denied E&M Claims with Chiropractic Manipulative Therapy (CMT)

The observed an increasing number of denied Evaluation and Management (E&M) claims (99201-99215) when billed concurrently with chiropractic manipulation procedures, including chiropractic manipulative therapy (CMT), highlighting the potential for increased claim denials with Chiropractic Manipulative Therapy (CMT). Denial Reasons & Misconceptions: Common denial reasons include: “Service billed is included in another procedure billed the same […]
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Pulmonary Hypertension Coding

Pulmonary Hypertension Coding: A Guide to Accurate Documentation

Pulmonary hypertension (PH) is a “frequently identified, highly morbid condition” associated with increased mortality, hospitalizations, and significant financial burden. What steps can you and your provider take to ensure this condition is both documented and coded correctly? Below are four strategies to improve your Pulmonary Hypertension coding practices. 1. Understand Pulmonary Hypertension (PH) The Pulmonary […]
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Dermatology coding

Guide to Dermatology Coding: Skin Lesion Removal Procedures

Proper Dermatology coding for skin lesion removal procedures hinges on understanding key factors such as the type of removal, depth, intent, lesion size, and location. Dermatology coding can seem overwhelming, given the intricacies of selecting the correct codes. Accurate code selection requires careful consideration of procedural details and clinical documentation to ensure compliance and prevent […]
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Acupuncture CPT Codes

Master Acupuncture CPT Codes: Improve Billing & Reimbursement

Acupuncture is a time-honored practice that has gained recognition in modern healthcare systems worldwide. However, for acupuncture providers, navigating the intricate world of Current Procedural Terminology (CPT) codes can be challenging. Accurate coding of acupuncture CPT codes is essential for reimbursement, compliance, and seamless claim processing. This guide dives deep into the nuances of acupuncture […]
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Diabetes Mellitus coding

Understanding the Complexities of Diabetes Mellitus Coding in ICD-10-CM

Diabetes mellitus is a multifaceted condition, and its Diabetes mellitus coding reflects that complexity. This article focuses on the role of medications in diabetes management and highlights the challenges coders face when assigning accurate codes for medication administration and related procedures. Why Is Diabetes Coding So Complex? Diabetes coding requires careful consideration of multiple factors, […]
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Medical Coding Denials

Top Strategies to Prevent Medical Coding Denials

Medical coding denials are a common challenge for healthcare providers and revenue cycle management (RCM) teams. They can disrupt cash flow, delay reimbursements, and increase administrative workloads. Avoiding these denials requires a proactive approach that addresses their root causes, ensures compliance with regulations, and fosters a culture of continuous improvement. In this blog, we’ll explore […]
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