Category: Medical Coding

Coding Mammograms

Medicare Retires G Codes for Mammograms

Ensure that your practice’s medical coding for preventive screening mammograms aligns with the most recent guidelines during Breast Cancer Awareness Month in October. Coding Mammograms for Medicare The Centers for Medicare & Medicaid Services (CMS) now acknowledges the CPT® mammogram codes, aligning with industry standards. This streamlines the process for coders to accurately document mammogram […]
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ICD-10-CM Code

New ICD-10-CM Code Rationales

Rationales for ICD-10-CM updates are key to improved medical coding, data reporting, and physician reimbursement. Many of the ICD-10-CM updates for 2020, presented at the ICD-10 Coordination and Maintenance Committee meeting on Sept. 11-12, 2018, provide insight into the purpose of subsequent code changes, which can help you to use the updated code set more […]
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coding of vaping

The Coding Conundrum: Vaping-Related Lung Injury

Confusion persists for the coding of vaping. The Centers for Disease Control and Prevention (CDC) is currently investigating vaping-related illnesses that have recently been reported. There are 450 confirmed or suspected cases in 33 states. The first death was reported on Aug. 23, 2019, in Illinois. The concern has escalated to the point that the […]
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Value-Based Care Models

Verma Presses Hospitals to Assume Risk in Value-Based Care Models

Hospitals assuming downside financial risk under value-based care models is the key to lowering healthcare costs and improving quality, CMS believes. CMS Administrator Seema Verma urged hospitals on Tuesday to accept new value-based care models and price transparency requirements or face greater administrative burden, less competition, and lower reimbursement rates under Medicare for All. “Our choices are […]
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EM Guidelines

What Happens When E/M Guidelines Change?

Medical coders, billers, auditors, and other healthcare business professionals started Day 2 of AAPC’s Regional Conference in New York City getting the scoop on the proposed changes to evaluation and management (E/M) services coding and E/M guidelines. E/M Guidelines Changes Are About Time Conference attendees were eager to hear Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, […]
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Billing and coding errors

Identifying & Addressing Common Medical Billing Errors Pre- & Post-Payment

It is estimated that as high as 80 percent of medical bills contain errors.1 As healthcare costs continue to rise, so too is the need for healthcare payers to reduce overspending resulting from avoidable billing errors and improper claims reimbursement. Given the sheer volume of claims submitted each day, capturing and reconciling discrepancies based off of […]
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ICD-10-PCS Updates

ICD-10-PCS Changes: 20 Codes Deleted For FY 2020

CMS has provided ICD-10-PCS updates for fiscal year 2020 that include 2,056 deletions. Here are 20 of the deleted codes: 0370046 – Dilation of right internal mammary artery, bifurcation, with drug-eluting intraluminal device, open approach 0372046 – Dilation of innominate artery, bifurcation, with drug-eluting intraluminal device, open approach 0374056 – Dilation of left subclavian artery, bifurcation, with […]
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CPT code 99201

Understanding Why 99201 Will be Deleted

An overview of the proposed Medicare Physician Fee Schedule: The proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially released on Aug. 14, 2019, encompassing various elements. Among these are proposals such as adjusting the PFS conversion factor to $36.09, introducing new HCPCS codes for bundled episode-of-care treatment for opioid use disorders, revising […]
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