Category: Medical Coding

Chronic Care Management Codes

Chronic Care Management Code Use Increases, But Uptake Still Lagging

Providers are increasingly using chronic care management (CCM) codes to address care fragmentation issues for patients with multiple chronic conditions. However, utilization patterns among providers could indicate some unaddressed challenges, according to a new study. The study recently published in the American Academy of Family Physicians examined publicly available Medicare data from 2015 to 2018. The data captured all […]
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2020 Coding Guide

2020 Coding Guide: Get Paid What You’re Owed

  There’s nothing more frustrating than rendering a service and not being paid. Sometimes the problem comes down to a single code. Nuanced coding rules are difficult to understand, and physicians aren’t taught this information in medical school. Still, health care is a business. As business owners, physicians need to know how they’re paid, including […]
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New COVID-19 Codes

New COVID-19 Codes Coming

  Twice a year, in March and September, the Centers for Medicare & Medicaid Services (CMS) ICD-10 Coordination and Maintenance (C&M) Committee meets, and the public is encouraged to participate. I personally find it extremely rewarding. I feel like I am contributing to the evolution of the ICD-10-CM code set. I had aspired to attend […]
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ICD-11 Transition

Rules Are Changing: The Impending Transition to ICD-11

The World Health Organization (WHO) updates ICD codes every 10 years to improve clinical use and acknowledge innovations in healthcare. After the tumultuous transition to the 10th revision of the International Classification of Diseases, simply mentioning the phrase “ICD-11” is liable to strike fear in the hearts of revenue cycle professionals and healthcare providers across […]
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New CPT Codes for COVID-19

AMA Approves 2 New CPT Codes for COVID-19

One of the codes, CPT Code 99072, is for reporting additional supplies used to mitigate spread of the virus. The American Medical Association (AMA) announced, Sept. 8, two new Category I CPT® codes to meet the changing needs of the healthcare industry brought about by the COVID-19 public health emergency (PHE). The codes were approved […]
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COVID-19 Coding and Claims Requirement

Providers Confused by COVID-19 Coding, Claim Requirements

Erratic claim volumes and confusion over COVID-19 coding and claim requirements are the top issues impacting revenue cycle operations, according to a new survey of financial leaders at US hospitals and health systems. Conducted through the Healthcare Financial Management Association’s (HFMA) Pulse Survey program, the survey commissioned by Alpha Health asked 587 chief financial officers and revenue cycle leaders […]
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2021 ICD-10-CM Codes

See What’s New for ICD-10-CM 2021

Make sure your diagnosis coding is up to date by reviewing this chapter-by-chapter summary of the changes effective October 1. The future is here, and it brought diagnosis codes for hoverboard accidents. But that’s not all that’s changed in ICD-10-CM 2021, effective Oct. 1, 2020, through Sept. 30, 2021. Below are highlights from the 56-page […]
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2021 Inpatient Prospective Payment System Rule

CMS Releases Long-Awaited 2021 FY IPPS Final Rule

  Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) final rule. The […]
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CPT Code Set Simplifies EM Coding

2021 CPT Code Set Simplifies E/M Coding, Adds COVID-19 Tests

  The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services. The code set released earlier today modified E/M office visit codes 99201 through 99215 to eliminate history and physical exam as […]
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2021 E/M CPT Coding Update

CPT Code for 2021

In the upcoming year, medical coders can anticipate a more streamlined process in adapting to the revised code set, which encompasses alterations in E/M codes and more. Notably, the CPT® Editorial Panel has sanctioned a smaller number of new codes for 2021, providing a welcomed respite. This is particularly relieving in light of the comprehensive […]
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