Coding professionals should familiarize themselves with three new measures in particular. In 2009, the Centers for Medicare & Medicaid Services (CMS) implemented a quality data reporting program for hospital outpatient services. The Hospital Outpatient Quality Reporting Program (Hospital OQR) is a pay-for-quality data reporting program mandated by the Tax Relief and Health Care Act […]
The heart of the principal diagnosis selection is pivotal to accuracy and compliance. Since February is known as “National Heart Month,” a discussion on the heart of inpatient coding is appropriate, that being the “principal diagnosis.” When learning inpatient coding, a large amount of time is spent on understanding the guidelines, conventions, and application of […]
On Jan. 14, coders and billers gained insight into proper use of novel HCPCS Level II modifier FT Unrelated evaluation and management (e/m) visit during a postoperative period, or on the same day as a procedure or another e/m visit. (report when an e/m visit is furnished within the global period but is unrelated, or […]
The organization released new CPT codes for Pfizer’s pediatric COVID-19 vaccine once FDA grants emergency use authorization for children between six months and five years of age. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a new code for administering pediatric doses of Pfizer’s COVID-19 vaccine in […]
Effective April 1, 2022, hospitals will have nine new procedure codes to describe the introduction or infusion of therapeutics, including the additional COVID-19 vaccines recently authorized for emergency use by the Food and Drug Administration. April Update The Centers for Medicare & Medicaid Services first introduced seven new ICD-10-PCS codes for the second quarter […]
A physician’s workday is often segmented into two major jobs: Seeing patients and performing the necessary administrative duties to ensure they are paid for work they have performed. Burnout is always a significant risk in any medical practice. It’s mostly caused by doctors and other clinicians having to see too many patients in too little […]
There are 200 new codes, 62 revised titles, and 107 deleted codes. The Centers for Medicare & Medicaid Services (CMS) released a new erratum for ICD-10-PCS on Jan. 12. Two additional procedure codes will be effective April 1, 2022. These codes have also been added to V39.1, Medicare Severity Diagnosis Related Groups (MS-DRGs). The […]
MDM elements during a preventive visit Q: Is it appropriate to count laboratory tests and other tests ordered during a preventive medicine service (99381-99397) visit in medical decision making (MDM) selection? No, because the 2021 revisions to the E/M office or other outpatient MDM do not apply to codes 99381-99397 (preventive services). These codes are […]
You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You provide excellent care for your patients and achieve great outcomes. […]
As part of its ongoing mission to improve the health of America, the Blue Cross Blue Shield Association (BCBSA) announced its National Health Equity Strategy in April 2021 to confront the nation’s crisis in racial health disparities. This strategy is intended to change the trajectory of health disparities and reimagine a more equitable health care […]