Category: Medical Coding

New ICD-10-PCS Codes for COVID-19

CMS Releases New ICD-10-PCS Codes for COVID-19

New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021. The procedure codes introduce six specific medications that can be used for treatment of COVID-19. The drugs […]
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2021 Physician Fee Schedule

Expect Give and Take in 2021 Physician Fee Schedule

After a slight delay, the Centers for Medicare & Medicaid Services (CMS) has finalized 2021 payments and policies under the Medicare Physician Fee Schedule (PFS). Most notably, the final rule makes permanent several telehealth flexibilities introduced during the public health emergency (PHE) for the COVID-19 pandemic while also significantly overhauling reimbursements for many services related […]
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2021 CPT Code Changes

Master 2021 CPT Changes With This Expert Overview

CPT® 2021 includes 206 new codes, 69 revised codes, and 54 deleted codes. All sections of CPT® received changes in codes and guidelines, except Anesthesia. The most significant changes are to codes for office/other outpatient evaluation and management (E/M), prolonged services, breast repair and reconstruction, cardiovascular shunting procedures, and COVID-19 testing. Here is an overview […]
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New PPE Code

CPT/AMA Announces a New PPE code – But is it Payable?

Some third-party payers have reimbursed and will continue to reimburse providers for this new CPT code; others won’t. The American Medical Association (AMA) published a new CPT® code on Sept. 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency (PHE). The code is effective immediately: CPT 99072 – Additional supplies, materials, and clinical staff time over and above […]
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Office-Visit Code Changes

6 Big Changes Coming for Office-Visit Coding

Physicians will soon start having an easier time — and perhaps get paid more money — when they code for evaluation and management (E/M) services, thanks to the American Medical Association (AMA). The first major changes to the definitions for E/M services will be in effect as of January 1, 2021, with all payers expected […]
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MPFS Telehealth Rule

CMS Finalizes 2021 Physician Fee Schedule, Including E/M Changes

After some delay due to the COVID-19 pandemic, CMS has released the final rule for the 2021 Medicare Physician Fee Schedule. The final rule unveiled by CMS yesterday evening will dictate how much Medicare physicians get paid for delivering care starting January 1, 2021. In the rule, CMS finalized a conversion factor of $32.41, which is a […]
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Flexible 2021 MPFS rule

2021 Medicare Pay Schedule Eases Physicians’ Documentation Burdens

The final 2021 Medicare physician payment schedule includes a simpler, more flexible process for coding and documenting evaluation and management (E/M) office-visit services. But those positive changes, set to take effect in January, are accompanied by significant pay cuts for many physicians in specialties that provide relatively few office visits—cuts that come as the pandemic […]
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COVID-19 Antibody Therapy

Two New Codes for COVID-19 Antibody Therapy

A new investigational monoclonal antibody therapy for Medicare patients with mild to moderate COVID-19 warrants new codes. The Centers for Medicare & Medicaid Services (CMS) announced Dec. 3 that it is implementing two new HCPCS Level II codes for Regeneron’s antibody casirivimab and imdevimab (REGN-COV2), effective for dates of service on or after Nov. 21. How To […]
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Refining Coding Productivity and Efficiency

10 Tips for Refining Your Coding Productivity and Efficiency

Coding professionals face a new landscape in today’s evolving job market where productivity and results are the main drivers behind the operational and financial health of the organizations they support. With artificial intelligence (AI) and natural language processing (NLP) advancing at a rapid rate, it is imperative that coding professionals remain competitive and are equipped […]
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