Dodge denials for drug testing by knowing which details demand attention. How often do you experience denials when it comes to your definitive drug testing? If the answer is often, this article may provide some answers to why that might be happening. Many payer policies have very clear guidelines, both medical and reimbursement, that dictate […]
Ever since a public health emergency (PHE) for COVID-19 was declared on Jan. 27, 2020, there has been several new HCPCS Level II codes created for monoclonal antibody (mAb) products and administration. As confusing as all these new codes and billing requirements have been, nothing has caused as much trouble as the latest change […]
Take 5 to read up on recent coding and billing news. There are plenty of coding updates in November, including those made to certain Medicare policies. Payment thresholds for physical, occupational, and speech-language pathology are also posted for the 2022 calendar year, as are Medicare cost sharing amounts. And HCPCS Level II code set updates […]
In first-quarter 2022, the HCPCS Level II code set will get a refresh with several new, revised, and deleted codes. According to the Centers for Medicare & Medicaid Services (CMS), there are: 155 new codes, 63 revised codes, and 48 deleted codes. Medical coders and billers: Familiarize yourself now with these code changes so you’re […]
The CPT® 2022 edition incorporates a total of 249 novel codes, along with 93 codes that have been revised, and 63 codes that have been removed. Every segment of the CPT® code set has undergone modifications to codes and guidelines. The most substantial revisions are observed in evaluation and management (E/M) codes, spine-related procedures such […]
What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II codes for COVID-19 therapeutic injections; and Medicare payment allowances for the 2021-22 influenza vaccine codes have been released. FDA Approves COVID-19 Vaccine Pfizer’s COVID-19 vaccine received the […]
C9076 is the newest addition to the list of HCPCS Level II codes for CAR-T therapies, effective July 1. Learn the latest changes to reporting products and procedures related to Chimeric Antigen Receptor (CAR) T-cell therapy to ensure proper medical coding and billing of CAR-T services furnished to Medicare patients. Review the Basics CAR-T […]
Current issue includes most frequently asked questions about coding COVID-19. The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the proper use of the ICD-10-CM/PCS systems and Level I HCPCS (CPT-4 codes) for hospital providers – and certain Level II HCPCS codes for hospitals, physicians, and other health professionals. The […]
After a slight delay, the Centers for Medicare & Medicaid Services (CMS) has finalized 2021 payments and policies under the Medicare Physician Fee Schedule (PFS). Most notably, the final rule makes permanent several telehealth flexibilities introduced during the public health emergency (PHE) for the COVID-19 pandemic while also significantly overhauling reimbursements for many services related […]
Labs soon will have to work harder to merit the maximum allowed Medicare payment for high-throughput tests used to detect SARS-CoV-2. The Centers for Medicare & Medicaid Services (CMS) has been paying labs $100 per test — up from $51 — since a public health emergency (PHE) for COVID-19 was declared on March 18, 2020. […]