Tag: CPT coding services

CPT Codes

The Three Categories of CPT Codes

Table of Contents Category I CPT Codes Category II CPT Codes Category III CPT Codes CPT Code Series and CPT Code List 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 […]
New Billing Codes-for Prior Authorization Work Proposed by AMA

AMA Aims to Streamline Prior Authorization Billing with New Codes

New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
Preventive-Visits-VS-Office-Visits

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
CPT 2024 Coding Updates

CPT 2024 Coding Changes Impacting General Surgery and Specialties

The American Medical Association (AMA) Current Procedural Phrasing (CPT)* code set is overhauled every year. This year, numerous of the upgrades are time-based codes, which may influence when they may be detailed. This article depicts CPT 2024 Coding Updates that are pertinent to common surgery and related specialties. Hyperthermic Intraperitoneal Chemotherapy in CPT 2024 Coding […]
Intricacies-of-Evaluation-and-Management-Coding

Navigating E&M Code Changes

It is expected that the Centers for Medicare & Medicaid Services (CMS) will release a completely revamped version of the evaluation and management (E&M) codes by 2021, particularly for the office visit codes (999201-99205 and 99211-99215). In addition to the changes to the office visit codes, there were significant changes to the 2023 guidelines. These […]
Complex Coding Procedure

6 Strategies for Accurate Coding for Complex Procedures

In the healthcare industry, accurate coding is crucial for ensuring proper reimbursement, maintaining patient records, and conducting data analysis. This becomes particularly important when dealing with complex procedures, which often involve multiple steps, specialized equipment, and nuanced documentation. Errors in coding for complex procedures can lead to a cascade of issues, including delayed payments, inaccurate […]
cigna-updates-modifier-25-reimbursement-policy

Cigna Updates Modifier 25 Reimbursement Policy

Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]

AMA Releases 2019 CPT Code Set

There were many code revisions with guidelines, descriptions and instructional note changes.    There six new codes in the Evaluation and Management (E&M) section in CPT. Guidelines were revised for Interprofessional Telephone/Internet/Electronic Health Record Consultations. New codes 99451 and 99152 were added to report assessment and management services.  The codes are based on medical consultative […]