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. […]
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 […]
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 […]
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 […]
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 […]
AAPC’s senior VP of products answers more of your questions about coding for office and other outpatient services. Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in […]
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 […]
Released earlier than usual, the fiscal year (FY) 2022 ICD-10-CM Official Guidelines for Coding and Reporting became available online Monday, July 12, and include instructions for assigning novel code U09.9 Post COVID-19 condition (found under Section I.C.1.g.1). Familiarize yourself with the following new and revised guidance, effective October 1, to ensure proper diagnosis coding and […]
The Centers for Disease Control and Prevention (CDC) released the ICD-10-CM Official Coding and Reporting Guidelines for the 2022 fiscal year (FY) on July 12th. The latest edition comprises 115 pages, which marks an 11-page reduction compared to the FY 2021 version. These updated guidelines will come into effect for discharges and visits from October […]
Five tips to ensure better documentation and, along with it, better patient care and improved reimbursement. Providers and coders need a cooperative relationship, working toward a common goal of complete coding and positive reimbursement results, as supported by medical documentation. Here are five tips to ensure better documentation and, along with it, better patient care […]










