Tag: CPT Codes

Get Caught Up on Coding and Billing News

Get Caught Up on Coding and Billing News

New COVID-19 vaccine status codes, changes and corrections to the 2022 CPT code set, Medicare Physician Fee Schedule (MPFS) payment changes, and prior authorization code list changes — that’s what’s on the agenda this month. Read all about it! 3 New Codes Improve COVID-19 Vaccination Status An April 1, 2022, update to the 2022 ICD-10-CM […]
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Resolve Initial vs. Subsequent Encounter Misconceptions

Resolve Initial vs. Subsequent Encounter Misconceptions

End the sequela struggle for when to include a 7th character with this primer. ICD-10-CM codes aren’t just for coding; they’re also used for payments, statistics, and other health information management activities. Therefore, some codes are designed to meet certain episode of care requirements that translate into costs. For example, a code describing an acute […]
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2021 E/M Guidelines FAQ – December

2021 E/M Guidelines FAQ – December

  Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in Healthcare Business Monthly and the Knowledge Center blog. In the May issue we started to answer your […]
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The CMS Expands Medicare Coverage for Remote Patient Monitoring

The CMS Expands Medicare Coverage for Remote Patient Monitoring

  CMS has been incrementally expanding coverage for remote patient monitoring since first recognizing the platform in 2019. Through RPM, healthcare providers can use digital health tools and telehealth platforms to improve care management for patients at home, especially those with chronic conditions or who’ve been recently discharged from a hospital. The platform has the […]
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New ICD-10-CM_PCS Codes Released

New ICD-10-CM/PCS Codes Released

The implementation of the new codes is April 1, 2022. The new ICD-10-CM/PCS codes for implementation on April 1, 2022, were recently released by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). The CMS v39.1 version of the MS-DRG grouper will be released in February 2022. […]
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early-warning-hospital-billing-errors-portend-bleakness

Early Warning: Hospital Billing Errors Portend Bleakness

Hospitals across the nation are seeing lower profits, and it’s all because of a sudden tsunami of Medicare and Medicaid provider audits. Whether it be by Recovery Audit Contractor (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), or otherwise, hospital audits are rampant. Billing errors, especially “supposed bundling,” are causing a high rate […]
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2021 E/M Changes: Are You Coding Unique Tests Properly?

2021 E/M Changes: Are You Coding Unique Tests Properly?

Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
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AMA Issues More COVID-19 Vaccine Codes

AMA Issues More COVID-19 Vaccine Codes

 The American Medical Association’s (AMA’s) CPT® Editorial Panel has released eight new COVID-19-related codes to report a new formulation of the Pfizer vaccine, a Moderna booster vaccine, and a Pfizer booster using either the new or old formulation. These codes are in addition to the four new CPT codes released last month and the many […]
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