Tag: Medical Coding Companies

AMA Updates CPT Codes for Pediatric COVID-19 Vaccine

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 […]
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Common coding mistakes and how AI is resolving them

If a medical student’s classes reflected the reality of practicing medicine today, I would venture that more than half of the curricula would be focused on performing administrative work, including the very complex task of coding. Accurate coding is one of the most intricate and often frustrating tasks that doctors and staff must do. Countless […]
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9 New Introduction Codes Added to ICD-10-PCS

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 of […]
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More ICD-10-PCS Codes Released for April 2022

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 new […]
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Medical decision making and coding

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 […]
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Coding audits 101: How physicians can prepare

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. No […]
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Health Equity and SDOH: A Payer Perspective / Update

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 […]
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When To Report an Incidental Finding

DOJ lawsuits may be your road map to risk adjustment compliance. The growing prevalence of risk adjustment in healthcare has forged new processes in documentation practices that have resulted in many organizations adopting practices that bend the cast iron rules for ICD-10-CM coding. We are starting to see some of the long-term dangers of ambitiously […]
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Understand Critical Care Before You Code

A solid understanding of guidelines and COVID-19-related complexities will limit claim denials and audits. Deciphering documentation to determine what qualifies as critical care services can be challenging for medical coders and auditors. With limited critical care codes available for assignment, reporting may appear relatively straightforward at first glance. However, there are many considerations that coders […]
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