Hip and knee replacements are two of the most commonly performed elective surgeries, according to the American Academy of Orthopedic Surgeons. Review major joint anatomy and CPT coding for hip and knee revisions and replacements. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Pacemakers are small devices implanted in the chest to help regulate inconsistent heart rates. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down documentation and CPT coding for pacemaker insertions, repairs, and relocations.
National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) can throw a wrench in the Medicare billing process, delaying appropriate revenue. Learn how to apply recent guidance and best practices to resolve challenging edits.
CPT coding for psychotherapy and psychiatric diagnostic evaluations can be challenging, especially when these services are provided with office visits. Shelley C. Safian, PhD, RHIA, CCS-P , breaks down documentation and CPT coding for visit services provided with psychiatric care. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare waivers and flexibilities allow providers to deliver care via telecommunication technology during the COVID-19 public health emergency (PHE). Judith Kares, JD , reviews CPT coding for e-visits, virtual communication services, and telephone E/M services.
CMS withdrew the split/shared and critical care sections of the Medicare Claims Processing Manual and announced its intent to update coverage policies for these services. Prepare for changes to come by reviewing documentation, CPT coding, and billing guidance for split/shared and critical care services.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO , describes upcoming changes to CMS’ prior authorization program, including expansion of the program to include two additional outpatient services, effective July 1.
In the U.S., tympanostomy tube insertion is the most common ambulatory surgery performed on children under 15, according to StatPearls. Debbie Jones, CPC, CCA , reviews common types of ear infections and CPT coding for myringotomies with tympanostomy tube insertion. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
With the inpatient-only (IPO) list set to be phased out, HIM departments need to prepare for the larger operational and financial impacts. Consider how these changes will affect your organization.
Laura Evans, CPC, and Julia Kyles, CPC, break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
The Centers for Disease Control and Prevention reports that approximately 15 million people in the U.S. report experiencing acute joint pain due to arthritis. Shelley C. Safian, Ph.D., RHIA, CCS-P, reviews ICD-10-CM and CPT coding for lower extremity arthritis and procedures used to treat it.
Laura Evans, CPC , and Julia Kyles, CPC , break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section.
Essential newborn care includes services provided at the time of birth and over the first hours of life. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about E/M coding for these routine obstetric services.
Medicare auditors have identified failure to document time as a key flaw in claims for advance care planning (ACP), and the Office of Inspector General plans to conduct an audit of these services. Read up on documentation requirements and CPT coding for ACP to prevent claim denials.
Corneal dystrophies are a group of genetic, often progressive, eye disorders that alter functioning of the cornea. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , breaks down ICD-10-CM coding for corneal dystrophies and CPT coding for procedures used to treat them.
The most impactful overhaul to the E/M coding and documentation guidelines in 25 years went live January 1. The updated guidelines eliminate medical history and physical examination as required elements for reporting E/M codes 99202-99215. E/M coding for outpatient visits is now based on documentation of medical decision-making (MDM) or time spent on the encounter.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, CCDS-O, analyzes confusing E/M guidelines for time-based visits and prolonged services provided before or after a face-to face encounter.
Arthroscopic surgical procedures involve the insertion of a small scope into the interior of a joint, allowing the physician to view the joint without making a large incision through the skin. Review CPT coding for arthroscopic procedures of the hip and knee joints.
CPT neurology codes describe advanced techniques to evaluate and treat conditions of the brain, spinal cord, and nerves. This article details CPT coding for three procedural services used to assess neurological symptoms: electroencephalogram, electromyography, and auditory-evoked potentials testing.
Arthroscopic surgical procedures involve the insertion of a small scope into the interior of a joint, allowing the physician to view the joint without making a large incision through the skin. Review CPT coding for arthroscopic procedures of the hip and knee joints. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A vaginal cuff tear, also known as vaginal cuff dehiscence, is a severe complication of a hysterectomy . Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes about CPT coding for transvaginal and laparoscopic vaginal cuff repairs.
CPT® neurology codes describe advanced techniques to evaluate and treat conditions of the brain, spinal cord, and nerves. This article details CPT coding for three procedural services used to assess neurological symptoms: electroencephalogram, electromyography, and auditory-evoked potentials testing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In its February MLN Connects newsletter, CMS reminds providers that HCPCS add-on code G2211 for visit complexity is a bundled service under the Medicare Physician Fee Schedule, meaning the application of this code will not result in additional payment for a billed E/M visit service.
Review coronary anatomy and CPT coding for aortic and iliac repairs, as well as selective procedures used to treat vascular occlusions in the lower extremities.
Read about regulatory updates in the 2021 Medicare Physician Fee Schedule final rule impacting CPT coding for chronic and transitional care management services, and billing for COVID-19-related services.
Review coronary anatomy and CPT coding for aortic and iliac repairs, as well as selective procedures used to treat vascular occlusions in the lower extremities. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In the 2021 Medicare Physician Fee Schedule final rule, CMS announced new HCPCS add-on code G2211 for visit complexity inherent to E/M services. Julia Kyles, CPC, describes when and how to report G2211 with E/M codes 99202-99215.
Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I, HCISPP , writes about CPT coding for total hip arthroplasty and autologous chondrocyte implantation: two orthopedic procedures that were recently removed from the inpatient-only (IPO) list for 2021.
Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them.
Section 1862 (l) and Section 1869 (f)(2)(B) of the Social Security Act (the Act) sets forth general procedures to develop and evaluate Medicare coverage determinations that are either adopted nationally by CMS or created and applied locally by a Medicare Administrative Contractor (MAC) within the MAC’s own jurisdictional boundaries.
This article details 2021 updates to CPT® codes for medicine services including several new codes for continuous electrocardiogram (ECG) recordings and auditory-evoked potentials (AEP), as well as American Medical Association (AMA)-approved CPT codes for COVID-19 immunizations.
The Medicine chapter of the CPT Manual covers a wide variety of services applicable to multiple specialties. Review calendar year 2021 updates to CPT® codes for medicine services including new codes for continuous electrocardiogram recordings and auditory-evoked potentials. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The calendar year 2021 Medicare Physician Fee Schedule (MPFS) final rule will have a significant impact on physician health systems. Review the implications of updated coding and payment policies that will boost payment for certain E/M services and cut the Medicare conversion factor by 10.2%.
Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In this article, Laura Evans, CPC, reviews 2021 E/M coding for outpatient encounters based on provider documentation of medical decision-making (MDM). She breaks down the four levels of problems addressed and describes the types of conditions that would fall into each category.
Modifiers provide a means by which a physician or facility can flag a service that has been altered by a special circumstance but has not changed in definition or code. Break down CPT guidelines for reporting hospital modifiers -25, -50, -59, -LT, and RT.
CMS' new final rule prepares for vaccine coverage for Medicare, Medicaid, and commercial insurers without any out-of-pocket costs. CMS will pay for any coronavirus vaccine that receives FDA authorization either through an Emergency Use Authorization or via a license under a Biologics License Application.
A multi-organizational collaborative is proving further evidence of the growing interest in behavioral health integration with primary care. Read about organizational efforts to improve collaboration between primary care and mental health providers and enhance billing for behavioral health services.
Modifiers provide a means by which a physician or facility can flag a service that has been altered by a special circumstance but has not changed in definition or code. Break down CPT guidelines for reporting hospital modifiers -25, -50, -59, -LT, and RT. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Medical Association (AMA) released two new CPT codes October 7 for reporting antigen tests that detect the novel coronavirus (COVID-19) and influenza.