Tag: medical-coding

New-PLA-Codes-in-Q3-of-CY-2022

23 New PLA Codes in Q3 of the CY 2022

A quarterly update to the Clinical Laboratory Fee Schedule (CLFS), issued by the Centers for Medicare & Medicaid Services (CMS) on Aug. 11, includes 23 new CPT® codes for proprietary laboratory analyses (PLA) tests. Medical coding and billing staff processing claims for lab testing should be aware of these code changes that are effective Oct. […]
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Coding Drives Up Medical Billing Costs in the US

Coding Drives Up Medical Billing Costs in US

Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
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AMA Announces CPT Code for Moderna COVID-19 Vaccine for Young Kids

While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a CPT code to ensure healthcare professionals are prepared for the shot’s potential use. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for […]
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Cms proposes more than 1k new diagnosis codes

Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of the 1,495 proposed changes to the ICD-10-CM diagnosis code set by CMS in the fiscal year (FY) 2023 inpatient prospective payment system (IPPS) proposed rule. At the same time, CMS also introduced a minimal amount of new ICD-10-PCS procedure codes, […]
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professional-hospital-e-m-charge-index-continued-to-grow-in-2021

Professional, Hospital E/M Charge Index Continued to Grow in 2021

In addition to the hospital E/M charge index rising, prices for professional evaluation and management, surgery, medicine, and radiology services increased last year. The median charge index for hospital evaluation and management (E/M) visits increased by 7 percent during the COVID-19 pandemic, according to a white paper from FAIR Health. The FH Medical Price Index […]
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master-2022-cpt-changes-with-this-expert-overview

Master CPT® 2022 Coding With This Expert Overview

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 […]
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The Impact of Coding on Maternal Outcomes: Part III

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 […]
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2021 E/M Changes: Are You Coding Unique Tests Properly?

Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
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COVID-19 AHA/AHIMA FAQ Revisions Made

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, “revised […]
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