Tag: CPT Codes

2022-care-management-services-codes-to-know

2022 care management services codes to know

Question: Can you please tell us what the new codes are for principal care management and chronic care management? Answer: There are three new codes in the care management section of the CPT codebook. Care Management Services Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” […]
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the-challenges-of-billing-observation-correctly

The Challenges of Billing Observation Correctly

Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]
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learn-about-opps-changes-in-july-update

Learn About OPPS Changes in July Update

Please be mindful that several coding and billing alterations pertaining to outpatient claims have been backdated to either April or January. Numerous modifications to Medicare’s Outpatient Prospective Payment System (OPPS) in the July update closely mirror those in the Medicare Physician Fee Schedule Database (MPFSDB) update for the same quarter. These include the introduction of […]
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take-the-complexity-out-of-behavioral-health-coding

Take the Complexity Out of Behavioral Health Coding

The secret to ensuring both proper payment and compliance is in the details. Why is mental health coding so complex? Laurie Bouzarelos, MHA, CPC, asked and answered that question in her presentation “Coding and Billing for Psychiatry and Outpatient Mental Health Providers” at AAPC’s virtual HEALTHCON 2022, March 27-30. Bouzarelos manages to take much of […]
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use-0074a-for-covid-19-pediatric-booster

Use 0074A for COVID-19 Pediatric Booster

Limit this code to administration of the Pfizer-BioNTech vaccine. On May 17, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to authorize the use of a booster dose for patients 5 through 11 years of age. The CPT® code to report administration of this […]
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preventive-medicine-versus-em-codes-the-same-day-coding-dilemma

Preventive Medicine Versus E&M Codes

Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to […]
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ama-announces-cpt-update-covid-19-booster-candidates

AMA announces CPT update for COVID-19 booster candidates

The American Medical Association (AMA) today announced an editorial update to Current Procedural Terminology (CPT®), the nation’s leading medical terminology code set for describing health care procedures and services, that includes newly assigned provisional CPT codes for COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline. The Pfizer booster candidate is proposed for use in children ages […]
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proper-procedural-and-coding-training-ensure-accurate-reimbursement

Barostim Heart Failure Treatment: Proper Procedural and Coding Training Ensure Accurate Reimbursement

  The Centers for Medicare & Medicaid Services (CMS) has begun covering a portion of the device cost for Barostim Neo, a neuromodulation device for treating chronic heart failure. In late 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin covering a substantial portion of the cost of implantable heart […]
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