Category: Medical Coding

New Code for E-Cigarette Associated Lung Injury

New Code for E-Cigarette/Vaping Associated Lung Injury (EVALI Code)

Emergency release of the new EVALI code by CDC. On Dec. 9, 2019, the Centers for Disease Control and Prevention (CDC) published additional guidance regarding e-cigarette/vaping associated lung injury (EVALI Code). The new code is U07.0 (Vaping-related disorder). The CDC consulted with the World Health Organization (WHO) regarding an addition to the classification that would […]
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AI Streamlines Medical Billing and Coding

How AI Streamlines Medical Billing and Coding

Advanced technology like AI is streamlining medical billing and coding procedures for enhanced customer experiences. Artificial Intelligence in Medical coding and billing is a crucial viewpoint of healthcare. Reports revealed that by 2021, the medical billing outsourcing market is predicted to touch $16.9 billion. The coding and billing functionality transmutes patient record information into regulated […]
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AI Can Help Health Plans Become Member-Centric

How AI Can Help Health Plans Become Member-Centric

Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
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Prevent Medicare Claim Denials

Prevent Medicare Claim Denials in 2020

Medicare has been issuing beneficiaries new member cards with Medicare Beneficiary Identifiers (MBI) in place of Social Security Numbers (SSNs) for more than two years. 2019 was a phase-in period when Medicare would accept either a beneficiary’s Social Security Number or their new MBI on claims. Starting Jan. 1, 2020, CMS will reject any Medicare claim Denials […]
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New CPT Codes for 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 Code Activations Simplify Billing Reimbursements For Practices

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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CPT Updates

CPT Code Updates: Radiology, Emergency Medicine, and Behavioral Health Changes

Upcoming changes to the CPT code set include updates to radiology and medicine sections, effective for claims submitted on or after January 1. Radiology Updates Several radiology codes have been revised, added, or deleted: Revised Radiology Codes: 74022, 74210, 74220, 74230, 74240, 74246, 74250, 74270, 74280 New Radiology Codes: 74221 – Esophagus radiologic exam, double-contrast […]
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Preparing for ICD-11

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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