Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in 2007, and first released a preliminary version for evaluation and testing in 2016 – ironically, just one year after the U.S. finally adopted a clinical modification of the WHO’s ICD-10 […]
Severe maternal morbidity often intersects with cesarean deliveries. Reducing the number of cesarean deliveries can lower the maternal mortality rate, and one of the drivers of cesarean rates is thought to be induction of labor (IOL). In 2014, the American College of Obstetricians and Gynecologists (ACOG) adopted definitions for labor, labor induction, and augmentation of […]
While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact, the U.S. has twice as many maternal deaths than other high-income countries. To reverse this trend, The Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and the Agency for Healthcare Research […]
To prepare for potential FDA authorization, AMA has released new CPT codes for pediatric doses of the Pfizer COVID-19 vaccine. In September 2021, Pfizer and BioNTech shared the results of a Phase 2/3 clinical trial in which two doses of the vaccine elicited a strong immune response in children ages 5 to 11. Following the […]
The American Medical Association’s (AMA’s) CPT® Editorial Panel has released eight new COVID-19-related codes to report a new formulation of the Pfizer vaccine, a Moderna booster vaccine, and a Pfizer booster using either the new or old formulation. These codes are in addition to the four new CPT codes released last month and the many […]
The implication of an incorrect COVID-19 diagnosis can be profound. I made a mistake last week. I was told that the joint American Hospital Association/American Health Information Management Association (AHA/AHIMA) frequently asked questions (FAQ) regarding ICD-10-CM coding for COVID-19 had been updated, so I checked the website (https://www.codingclinicadvisor.com/faqs-icd-10-cm-coding-covid-19). On the introduction page, it stated, […]
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 […]
Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
There are a slew of changes and only a few months before you will need to start using the new codes. The Centers for Medicare & Medicaid Services (CMS) released on July 1 the ICD-10-CM code descriptions, tables and index, and addendum for fiscal year 2021. There are 490 additions, 58 deletions, and 47 revisions — […]
E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is that there’s a year to […]