Category: Medical Coding

2021 ICD-10 Coding Guidelines

ICD-10 Coding Guideline Changes For 2021

For 2021, there are 490 new, 47 revised and 58 deleted ICD-10-CM codes. We will cover the ICD-10-CM guidelines in this article and the ICD-10-CM code changes next month. There are several important changes to the guidelines, including those relating to COVID-19 coding. The updates for these were a little late this year due to […]
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Coding Denials

Coding Denials: Back to Basics

Coding must be supported by documentation, but also by the Official Coding Guidelines. While preparing for a clinical validation presentation on acute kidney injury denials, I took inventory of the most common denials and recoveries obtained by payers. It came as no surprise that sepsis, severe malnutrition, and encephalopathy were at the top of the […]
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Medicare Reimbursement or Telehealth

CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth services cover some cardiac and pulmonary rehabilitation services, as well as certain neurostimulator analysis and programming services. The additions to the Medicare telehealth list were made in […]
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Improving Coding Processes

Improving Coding Processes to Achieve Value-Based Care Success

Primary care physicians (PCPs) face increasing challenges in the current healthcare environment: not having enough resources to care for patients, declining practice revenues, and overwhelming administrative burdens. On top of all that, there is a necessary, but mounting pressure to shift to value-based care. Having run a cardiothoracic surgery practice for 25 years, I have […]
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clinical documentation and coding

3 Ways to Improve Medical Coding Quality for Accurate Reimbursement

Leveraging technology, auditing for compliance, and providing robust education are key ways providers can improve medical coding quality. While some have said medical coding sits quietly in the middle of the healthcare revenue cycle, it is a key step that, when done inadequately, can impact each part of the revenue cycle after it. Medical coding quality is […]
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Telehealth Coding Set

CMS Adds 11 Codes to Telehealth List

Physicians can now offer more services via telehealth and get paid. The Centers for Medicare & Medicaid Services (CMS) is adding 11 codes to the list of telehealth services payable under the Medicare Physician Fee Schedule (MPFS). Coverage is retroactive to March 1, 2020, and is effective for the duration of the public health emergency (PHE) for […]
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Medical COding Updates

6 Must-Know Coding Updates In 2020

  Becker’s ASC Review compiled a timeline of significant medical coding updates that have been proposed or implemented so far this year: January CMS began paying for certain angioplasty and stenting procedures in ASCs on Jan. 1, under its 2020 Medicare Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule. Here are the Current Procedural Terminology […]
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2021 EM Coding Changes

E/M Changes Take Effect January 2021

  Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of […]
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Facility Coding Guidelines

The Need for Facility Coding Guidelines

Facility-specific coding guidelines are key to code hospital visits and encounters consistently. Another role that facility-specific guidelines play is to capture all possible reimbursement that is due to an organization. Every Oct. 1, the MS-DRGs and ICD-10-CM/PCS are updated. In addition to the MS-DRGs, the New Technology Add-On Payments (NTAPs) are updated as well. It […]
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CPT Codes for Multi-virus Tests

New CPT Codes for Multi-Virus Tests Detect COVID-19 and Flu

The American Medical Association (AMA) today published an update to the Current Procedural Terminology (CPT®) code set that includes new code additions and editorial revisions for reporting medical services sparked by the public health response to the COVID-19 pandemic. The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened […]
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