Category: Medical Coding

EM Coding Guidelines

2021 E/M Guideline and Leveling Changes

Providers need a mechanism to be accurately reimbursed for the time and effort that they expend in providing care. Evaluation and Management (E/M) leveling has been the standard method in which to provide appropriate, defensible payments for services. However, it has been successfully argued that the 1995 and 1997 E/M guidelines in place today are […]
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10 Weird ICD-10 Codes

In this article, we going to discuss the 10 weird ICD-10 codes that most physicians haven’t had to use yet. W55.21 – Bitten By Cow ICD Code W55.21 is a non-billable code. To code a diagnosis of this type, you must use specify a 7th character that describes the diagnosis ‘bitten by cow’ in more detail. The […]
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2021 MPFS & Policy Upda tes

A View into Proposed Medicare PFS and Policy Changes for 2021

  The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it […]
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ICD-10 Codes for COVID-19 Symptoms

Do ICD-10 Codes Accurately Reflect COVID-19 Symptoms?

Although the integration of big data into health care has been increasing in recent years, the coronavirus disease 2019 (COVID-19) pandemic has brought this practice to the forefront, as many hospitals and care facilities struggle to keep accurate and timely records of COVID-19 cases while adhering to changing procedures implemented at the federal level. “The use of […]
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E&M revised Codes

What to Expect with the 2021 E&M Revisions

  A work group put together by the American Medical Association (AMA) that also represents the AMA’s Current Procedural Terminology (CPT) Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) has put together revisions to office and outpatient evaluation management (E&M). These will take effect on January 1, 2021. So how will this affect dermatologists? Well, […]
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Patient Counseling

CMS Announces New Payment Allocation for COVID-19 Patient Counseling

  CMS will leverage existing evaluation and management (E&M) payment codes to reimburse eligible providers for the coronavirus counseling services.  The Centers for Medicare & Medicaid Services (CMS) will make payment available to physicians and providers for counseling patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to […]
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Artificial Intelligence in Medical Coding

Artificial Intelligence Meets Medical Coding

  Medical billing and coding is an integral component of healthcare. The medical coding outsourcing market alone is projected to reach16.9 billion dollars by 2021. However, coding accuracy is an ongoing challenge. To maximize efficiency and accuracy of the medical coding process, companies are testing the possibilities of Artificial Intelligence (AI) applications. The current problem […]
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CPT Codes for Cardiovascular Services

Proposed Rule Introduces New CPT Codes For Cardiac Shunting, EKGS, And Lung Biopsies

Coders should also take note of the new HCPCS Level II codes CMS is considering. CMS released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) on August 3, introducing 39 new CPT codes, mainly for cardiovascular services. If finalized, the new codes will go into effect January 1, 2021. The proposed update includes five new codes for […]
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CPT Code for Coronavirus Testing

AMA Announces New CPT Codes for Coronavirus Testing

The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims. The newly introduced CPT codes are as follows: •86408: SARS-CoV-2 neutralizing antibody […]
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COVID-19 billing updates

CMS Pays for Coronavirus Counseling, Other COVID-19 Billing Updates

Provider reimbursement is now available to physicians who tell their patients to self-isolate at the time of COVID-19 testing, according to CMS. An announcement released late last week in collaboration with the Centers for Disease Control and Prevention (CDC) said CMS will leverage existing evaluation and management (E/M) payment codes to reimburse eligible providers for the coronavirus […]
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