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 […]
AAPC’s senior VP of products answers 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 Healthcare Business […]
New codes are effective Oct. 1, 2021. Highly anticipated, the fiscal year 2022 ICD-10-CM codes have been released by the Centers for Disease Control and Prevention (CDC), although still pending are the 2022 Official Coding and Reporting Guidelines which were not included in the package of new codes. We are still waiting for the release […]
The code 99417 is invalid for Medicare and MA reimbursement. When the CPT® Guidelines were updated for 2021, one of the options for leveling an office or other outpatient evaluation and management (E&M) service was to use time as the leveling agent. The time thresholds for each E&M office visit were also changed from “typical” […]
Retroactive code pricing updates may require claims lookback. The Centers for Medicare & Medicaid Services (CMS) has posted a retroactive update to the April Average Sales Price (ASP) pricing file for three Medicare Part B drugs. Also now available are the July ASP and Not Otherwise Classified (NOC) pricing files and the ASP NDC HCPCS […]
After three years of policy proposals, the American Medical Association Current Procedural Terminology (CPT) panel responses, and substantial guidance from gastroenterology and other specialty societies, changes to the office/outpatient evaluation and management (E/M) codes became effective as of January 2021. Some aspects of these revisions took effect for telehealth services since spring 2020 for Medicare, […]
Our hospital has been denied CPT code 52601 because the operative report does not mention the word complete. Although the operative note described the procedure in detail and the pathology report showed benign prostatic hyperplasia (BPH) tissue, why do we need to state the word complete? What does it mean in the CPT description? CPT […]
An ICD-10 Coordination and Maintenance Committee virtual meeting is scheduled for March 9–10, from 9 a.m. to 5 p.m. The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention National Center for Health Statistics (CDC NCHS) have posted tentative agendas on their websites. Stakeholders will present on a […]
A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]