Category: Medical Coding

How to Build ICD-10-PCS Codes From Op Reports

How to Build ICD-10-PCS Codes From Op Reports

Arrive at the correct procedure code by breaking down the operative report. Even seasoned coding professionals occasionally find it challenging to assign the appropriate ICD-10-PCS codes from the operative report. Mastering the procedural coding system used in the inpatient hospital setting takes practice. Medical coders reporting inpatient services should start by reading the operative report, […]
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Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

The heart of the principal diagnosis selection is pivotal to accuracy and compliance. Since February is known as “National Heart Month,” a discussion on the heart of inpatient coding is appropriate, that being the “principal diagnosis.” When learning inpatient coding, a large amount of time is spent on understanding the guidelines, conventions, and application of […]
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Medical decision making and coding

Medical decision making and coding

MDM elements during a preventive visit Q: Is it appropriate to count laboratory tests and other tests ordered during a preventive medicine service (99381-99397) visit in medical decision making (MDM) selection? No, because the 2021 revisions to the E/M office or other outpatient MDM do not apply to codes 99381-99397 (preventive services). These codes are […]
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Health Equity and SDOH: A Payer Perspective / Update

Health Equity and SDOH: A Payer Perspective / Update

As part of its ongoing mission to improve the health of America, the Blue Cross Blue Shield Association (BCBSA) announced its National Health Equity Strategy in April 2021 to confront the nation’s crisis in racial health disparities. This strategy is intended to change the trajectory of health disparities and reimagine a more equitable health care […]
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Resolve Initial vs. Subsequent Encounter Misconceptions

Resolve Initial vs. Subsequent Encounter Misconceptions

End the sequela struggle for when to include a 7th character with this primer. ICD-10-CM codes aren’t just for coding; they’re also used for payments, statistics, and other health information management activities. Therefore, some codes are designed to meet certain episode of care requirements that translate into costs. For example, a code describing an acute […]
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2021 E/M Guidelines FAQ – December

2021 E/M Guidelines FAQ – December

  Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in Healthcare Business Monthly and the Knowledge Center blog. In the May issue we started to answer your […]
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Master CPT 2022 Coding With This Expert Overview

Master CPT® 2022 Coding With This Expert Overview

The CPT® 2022 edition incorporates a total of 249 novel codes, along with 93 codes that have been revised, and 63 codes that have been removed. Every segment of the CPT® code set has undergone modifications to codes and guidelines. The most substantial revisions are observed in evaluation and management (E/M) codes, spine-related procedures such […]
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The CMS Expands Medicare Coverage for Remote Patient Monitoring

The CMS Expands Medicare Coverage for Remote Patient Monitoring

  CMS has been incrementally expanding coverage for remote patient monitoring since first recognizing the platform in 2019. Through RPM, healthcare providers can use digital health tools and telehealth platforms to improve care management for patients at home, especially those with chronic conditions or who’ve been recently discharged from a hospital. The platform has the […]
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The Impact of Coding on Maternal Outcomes_ Part III

The Impact of Coding on Maternal Outcomes: Part III

Severe maternal morbidity often intersects with cesarean deliveries. Reducing the number of cesarean deliveries can lower the maternal mortality rate, and one of the drivers of cesarean rates is thought to be induction of labor (IOL). In 2014, the American College of Obstetricians and Gynecologists (ACOG) adopted definitions for labor, labor induction, and augmentation of […]
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The Impact of Coding on Maternal Outcomes_ Part II

The Impact of Coding on Maternal Outcomes: Part II

Coding blood transfusions on maternity patients saves lives. If you are a “frontline” coder buried in the minutiae of day-to-day coding, discussions about quality initiatives may not be in the forefront of your brain. We often hear of the importance of these programs in improving patient outcomes, and how critical “accurate and consistent” coding is. […]
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