Category: Medical Coding

CPT codes self-measured BP

New Year, New CPT Codes for Self-Measured BP

Guidance for using out-of-office BPs is not new. Medical evidence and clinical guidelines published over the last decade have showcased the importance of 24-hour ambulatory monitoring as the reference standard, and self-measured blood pressure monitoring (SMBP) as an acceptable alternative for obtaining BPs to diagnose and treat hypertension. And thanks to that abundance of research […]
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J Codes simplify Reimbursement

J Code Activations Simplify Billing Reimbursements For Practices

Several CMS-designated permanent and product-specific J-codes recently went into effect, allowing three ophthalmology-minded pharmaceutical companies to expand reimbursement through commercial and Medicare insurance plans. J-codes were activated Oct. 1 for FDA-approved products manufactured by EyePoint Pharmaceuticals, Ocular Therapeutix and Omeros. In the past, J-codes were announced once a year; now, CMS is issuing certain J-codes […]
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HCC Coding

HCC Coding: Preparing for ICD-11

HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are HCC coding for hierarchical condition category (HCC) purposes, you know that HCCs are categories of related ICD-10 codes. Only selected significant conditions to drive a payment HCC coding. That means only conditions that […]
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Chiropractic Coding Changes

Chiropractic Code Changes For 2020

You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
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Outpatient Billing

Eight Things You Should Do Now To Clean Up Your Outpatient Billing

Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
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Medicare-reimbursement

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
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HCPCS Level II code changes

HCPCS Level II Code Changes for 2020

Centers for Medicare & Medicaid Services (CMS) unveiled the HCPCS Level II code modifications for 2020 on November 8th. These alterations encompass an extensive array of fresh, revised, and eradicated codes, serving as the means to document Medicare Part B services. The 2020 HCPCS Level II edition is set to incorporate a total of 191 […]
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