Category: Medical Coding

AMA on Evaluation and Management Service Codes Guidelines

AMA on Evaluation and Management Service Codes Guidelines

Medical coders who were unsure what documentation non-Medicare payers would expect in light of the Patients Over Paperwork Initiative now have more to go on. The initiative reduced documentation requirements for outpatient evaluation and management service codes (CPT® 99201-99215) provided to Medicare Part B patients beginning in 2021. The Centers for Medicare & Medicaid Services (CMS) indicated in their initiative that, although […]
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Correct Common OB/GYN Coding Mistakes

Overlooking separately billable services rendered during the global period will cost your practice dearly. Many obstetrics/gynecology (OB/GYN Coding) practices are coding deliveries incorrectly or failing to submit claims for “problem visits” during a prenatal or postpartum visit. Common mistakes such as these not only fail to capture payment for services rendered but also the meaningful […]
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Change To RT And LT Modifiers Use

Change To RT And LT Modifiers Use

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally. The […]
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CMS To Revamp Coding For New Medical Technology

CMS To Revamp Coding For New Medical Technology

Dive Brief CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technology. Medical device companies will now be able to apply for a new permanent Healthcare Common Procedure Coding System (HCPCS) code twice a year, instead of annually. CMS also recently eliminated […]
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Medicare Payments For Top 10 ASC Codes

Medicare Payments For Top 10 ASC Codes Through 2019

Medicare payments for the top 10 current procedural terminology codes performed by ASCs are expected to remain relatively stable in 2019 compared to 2018, according to VMG Health. 66984: Cataract surgery with insertion of intraocular lens prosthesis (one-stage procedure), manual or mechanical technique Estimated 2017 payments: $1,172 Estimated 2018 payments: $1,206 Estimated 2019 payments: $1,182 45380: […]
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HCPCS and CPT Codes

What’s New In 2019 For CMS

This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
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Moderate Sedation Coding

Moderate Sedation Coding

Moderate sedation coding, also sometimes referred to as conscious sedation, is a drug-induced depression of consciousness. A patient who has been sedated in this way is relaxed and generally insensitive to pain, but remains awake and able to respond to verbal instruction. If medically necessary and properly documented, moderate sedation is a separately reported service. […]
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5 Steps To Coding Success

Lesion Excision: 5 Steps To Coding Success

Lesion excision coding may seem complex, but reporting excision of benign (CPT Code 11400- CPT Code 11471) and malignant (11600-11646) skin lesions can be mastered in five steps. Step 1: Measure First, Cut Second: When assigning CPT® codes 11400-11646, you must know both the size of the lesion(s) excised and the width of the margins […]
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