Category: Medical Coding

Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
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Top Error Rates Offer Clues to Denials

Top Error Rates Offer Clues to Denials

The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
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6 Questions Ensure E_M Compliance

6 Questions Ensure E/M Compliance

Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
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CPT 2021 Update_ New Lab, Category III Codes

CPT® 2021 Code Updates: Second and Third Quarters

The American Medical Association (AMA) has released updates for the second and third quarters of CPT® 2021. These changes, including new, revised, and deleted codes, will be implemented in AAPC’s Codify system as they become effective. Practices should also update their CPT® 2021 code books and electronic health record (EHR) software accordingly. Proprietary Laboratory Analyses […]
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AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine

AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine

In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine. AMA assigned Category 1 CPT code 91302 to the vaccine manufactured by the Cambridge, United Kingdom (UK) company, as well as vaccine administration CPT codes […]
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CMS Releases HCPCS Codes For Covid-19 Antibody Drug

CMS Releases HCPCS Codes For Covid-19 Antibody Drug

  A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]
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CMS Releases 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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Master 2021 CPT Changes With This Expert Overview

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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