Category: Medical Coding

CMS Releases PCS Codes Final Rule

Medical/Legal Impact of 2021 E&M Changes

Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
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E_M Coding for 2021_ What’s New and Different

E/M Coding for 2021: What’s New and Different

After three years of policy proposals, the American Medical Association Current Procedural Terminology (CPT) panel responses, and substantial guidance from gastroenterology and other specialty societies, changes to the office/outpatient evaluation and management (E/M) codes became effective as of January 2021. Some aspects of these revisions took effect for telehealth services since spring 2020 for Medicare, […]
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CPT Coding For Excisional Wound Debridement With VAC

CPT Coding For Excisional Wound Debridement With VAC

Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2×4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)? A: The debridement would be reported using CPT code 11042 (debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq cm or less). This procedure […]
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AHA Coding Clinic on ICD-10-CM_PCS for First Quarter of 2021 Released

AHA Coding Clinic on ICD-10-CM/PCS for First Quarter of 2021 Released

Current issue includes most frequently asked questions about coding COVID-19. The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the proper use of the ICD-10-CM/PCS systems and Level I HCPCS (CPT-4 codes) for hospital providers – and certain Level II HCPCS codes for hospitals, physicians, and other health professionals. The […]
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ICD-11 Is Coming, Prepare Now

ICD-11 Is Coming, Prepare Now

IFHIMA makes the case for ICD-11 adoption with latest whitepaper. As healthcare transformation progresses due to the digitization of data and advancements in medical science and technology, it is increasingly important that nations around the world begin planning for adoption of ICD-11. The International Classification of Diseases (ICD) has a long and valued history of […]
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Append Surgical Modifiers With Confidence

Append Surgical Modifiers With Confidence

Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]
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Top Advantages of Employing AI in Medical Billing and Coding

Top Advantages of Employing AI in Medical Billing and Coding

In the realm of medical billing and coding, the incorporation of artificial intelligence stands as a pivotal advancement. Its role in healthcare establishments is to optimize billing procedures, thereby mitigating costly errors. Among the array of AI-driven technologies, machine learning and Natural Language Processing (NLP) take the forefront. These tools excel at swiftly and accurately […]
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