The CPT code set for 2024 has recently been released. The modifications discussed below pertain specifically to urology and will become effective on January 1, 2024, across all payers. While pricing and coverage details will be finalized for certain procedure codes, primarily for Medicare, with the release of the Medicare Physician Fee Schedule in late […]
Current procedural terminology meaning: Current Procedural Terminology or CPT codes are developed by the American Medical Association (AMA) to describe a wide range of healthcare services provided by physicians, hospitals, and other healthcare professionals. These codes are utilized to communicate with other physicians, hospitals, and insurers for claims processing. There are three categories of CPT Codes: […]
The CMS Releases July 2024 OPPS Update (reference: CMS Change Request CR13632, MLN Matters number MM13632). Here’s a summary of key changes: New Coverage for COVID-19 Pre-Exposure Prophylaxis: Drug: PEMGARDA (pemivibart) – Code: Q0224 (Note: This code is not reimbursed under OPPS, but at a “reasonable cost”) Administration: Code: M0224 (Covered: Receives separate payment under […]
Newly introduced as of July 1, 2023, are updated CPT® codes detailed in MLN Matters 13210, issued on June 13. Accompanying this, a supplementary document, Change Request 13210, offers more comprehensive insights. Included in the fresh set of codes are those related to COVID vaccination and its administration. Specifically, 0174A pertains to administering the Pfizer-BioNTech […]
An Ambulatory Surgical Center Payment System (ASC PS) update that took effect July 1, 2019, changes billing instructions for various payment policies and codes. Here is what you need to know to properly bill Medicare for these services and supplies. New CPT Category III Codes Effective July 1, 2019, the Centers for Medicare & Medicaid […]