Get Paid for COVID-19 Testing/Treatment of Uninsured
Payers are reimbursing providers for all COVID-19-related testing and treatment they are furnishing to their insured members, but what if
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Sneak a Peek at ICD-10-CM 2021
There are a slew of changes and only a few months before you will need to start using the new
Read moreJuly 2020 ASC Payment System Update
The Centers for Medicare & Medicaid Services (CMS) released the July 2020 update of the Ambulatory Surgical Center Payment System
Read moreExplore 2020 Cardiovascular System Code Changes
Familiarize yourself with the 2020 CPT® code updates for the cardiovascular system using this simplified guide. During these uncertain times,
Read moreClinical Trials Have a Place for Medical Coders
Research is a big job market often overlooked by healthcare business professionals. Healthcare is changing rapidly. New technology and drugs
Read moreDon’t Dismiss Juvenile Arthritis as Growing Pains
July brings awareness to juvenile arthritis: Learn about it to ensure proper diagnosis coding. When people hear that someone has
Read moreThe Rules Are Changing: ICD’s Continued Evolution and the Impending Transition to ICD-11
Part 1: Insight into the history of ICD and how it has changed over time is key to developing a
Read moreNew COVID-19 Test Codes Effective Immediately
Just when you thought you had all the COVID-19 coding for laboratory testing figured out — hold the phone —
Read moreIs There an NCCI Edit for Those Codes?
Know how to find the answer and improve your clean claims rate. Medicare revises its National Correct Coding Initiative (NCCI)
Read moreNCCI Tightens Up Cardio, Lab Edits July 1
Several procedure-to-procedure (PTP) edit changes in the Medicare National Correct Coding Initiative (NCCI) database will go into effect July 1.
Read moreICD-10-PCS 2021 Adds 544 New Codes
The 2021 ICD-10-PCS files are now available. Inpatient coders will have 544 new codes to work with beginning Oct. 1,
Read moreHCPCS Level II Code Changes in Effect July 1
C1748 Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable) C1849 Skin substitute, synthetic, resorbable, per square centimeter C9059 Injection,
Read moreTelemedicine Takes Healthcare Into the 21st Century
Update your understanding of how to code telehealth services now and in the future. Disclaimer: At press time, this information
Read moreLook for Clues When Coding Myocardial Infarction Interventions
Compliant reporting of myocardial infarction revascularization procedures is all in the timing. Does your staff know the coding guidelines for
Read moreHCC Coding for Post-Sepsis Syndrome
Capture risk adjustment payment for physicians who treat patients with late effects of sepsis. In the United States, more than
Read moreCode With Confidence
7 steps to set you down the path to coding claims with certainty. It has been my experience — both
Read moreIs It Alzheimer’s or Dementia?
Proper coding requires medical coders to know the difference. June is when we wear purple to recognize Alzheimer’s and Brain
Read moreTelehealth Coverage for Mental Health Services During COVID-19
As the global pandemic enters its fifth month, we are all feeling the strain. Staying home to slow the spread
Read moreHow Telehealth Services Factor Into Risk Adjustment
2020 has proven to be one of the most complex, busiest times in healthcare — in the 21st century, anyway.
Read moreClean Chiropractic Claims Require Coders to Know Where It’s “AT”
Ever since the publication of the Office of Inspector General’s (OIG’s) portfolio “Medicare Needs Better Controls to Prevent Fraud, Waste,
Read moreMedicare Telehealth Coding as of April 30
Healthcare providers are granted even more latitude for use of telehealth services during the COVID-19 public health emergency. When attending
Read moreMaximize Your Stroke Dx Coding
Tips to improve and streamline your stroke diagnosis coding processes. There are a lot of variables at play when it
Read more2020 Radiology and Imaging CPT® Changes
Become a coding superhero with X-ray vision. When is imaging separately reported, and how? The relative value units (RVUs) for
Read moreCalculating the Effect of the 2021 E/M Changes on Primary Care
Weigh the pros and cons as the healthcare industry prepares to implement new leveling guidelines. Unless you’ve been hiding under
Read moreExpert Documentation & Coding Practices in the EMR
Heightened documentation requirements and new technology require us to see the flaws in our EMRs and correct them. I’ve been
Read moreUsing Modifier 95 for Telehealth Makes Cents
Capture full payment for remote visits during the PHE for COVID-19. An interim final rule published in the April 6,
Read moreWorking as a Remote Coder During COVID-19
If you find yourself struggling to rapidly adjust to the ever-changing environment of the COVID-19 pandemic, you are not alone.
Read moreCoding High-Throughput COVID-19 Testing
The Centers for Medicare & Medicaid Services (CMS) created two new HCPCS Level II codes for lab tests that use
Read moreNew COVID-19 Testing Codes
During an emergency meeting in response to the COVID-19 crisis, the American Medical Association (AMA) convened the CPT® Editorial Panel
Read moreWaive Cost Sharing on Applicable Claims Using Modifier CS
The implementation of the Families First Coronavirus Response Act waives cost-sharing (coinsurance and deductibles) for COVID-19 testing-related services. The Act is
Read moreCOVID-19 Specimen Collection Codes
Clinical diagnostic laboratories can identify specimen collection for COVID-19 testing using two new HCPCS Level II codes, effective March 1,
Read moreGet the Most Out of New ICD-10-CM Addenda and Guideline Updates
On April 1, 2020, the National Center for Health Statistics (NCHS) formally issued updates to the ICD-10-CM List of Diseases
Read moreEase Central Pain Syndrome Coding in the IRF
Specificity will help your inpatient rehab facility meet the 60 percent rule. The opioid crisis has drawn a lot of
Read moreMaster the Art of Obstetrical Ultrasound Coding
Understand the coding mechanics behind some of the most common obstetrical US examinations. An outsider looking in might think diagnostic
Read moreCoding Newborn Attendance at Delivery and Resuscitation
Prepare for the unexpected when the patient is expecting. Oh, those cute little babies! All those fingers and toes and
Read moreICD-10-CM Coding for Spring Fever Mishaps
There’s a diagnosis code for every springtime affliction you can think of. Spring fever is not a definitive diagnosis in
Read moreVitamin D: Get Your Daily Dose
Deficient understanding of this essential vitamin could wreak havoc on your coding for related testing and diagnoses. Vitamin D testing
Read moreRemote Coding and Billing: Dream Job or Nightmare?
Working from home isn’t for everyone. Consider the pros and cons. Working from home can be a dream come true
Read moreTelehealth FAQ: You Asked, We Answered
Certain telemedicine services are already covered under the Physician Fee Schedule (PFS) when provided to Medicare patients in accordance with
Read moreBuild a Successful Outpatient CDI Program
Knowing when and how to query providers is key. Documentation deficiencies occur in both outpatient and inpatient settings, but clinical
Read moreFeds Extend Medicare Coverage During COVID-19 Pandemic
An unprecedented “relaxation” in regulatory guidelines will give U.S. hospitals and non-traditional care sites a fighting chance to meet the
Read moreTelehealth Coverage Expanded for Medicare Patients
The government is relaxing guidelines to ensure seniors get the healthcare they need during this national emergency. A sweeping expansion
Read moreNew CPT® Code for Reporting COVID-19 Test
On Jan. 30, the World Health Organization (WHO) declared the 2019 novel coronavirus (COVID-19) disease outbreak a public health emergency
Read moreCOVID-19 Coding Q&A: CPT®, HCPCS, and ICD-10-CM News for Coronavirus Coding
A lot of information is appearing very fast about COVID-19 (coronavirus disease 2019), and medical coders have the extra challenge
Read moreCode Change for Influenza Season 2020-2021
The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza
Read moreApril 1 Updates to MPFS Are no Joke
April 1 is around the corner and you know what that means: quarterly updates. The Centers for Medicare & Medicaid
Read moreAMA Releases CPT® Errata and Technical Corrections
CPT® 2020 Category I errata and technical corrections released by the American Medical Association (AMA), are effective Jan. 1, 2020.
Read moreBiopsy Coding Requires an Eye for Detail
Does your provider’s documentation contain all the information you need for correct coding? Unless the provider is descriptive in their
Read moreModifier 59 Is Over-Used and Abused, MAC Says
Failure to adopt the X[ESPU] modifiers may be putting your practice at risk for Medicare fraud. Modifier 59 Distinct procedural
Read more2020 OPPS Causes Fervor in the Industry
Price transparency overshadows all other finalized Medicare policy updates among hospitals. The Hospital Outpatient Prospective Payment System (OPPS) final rule
Read moreCoronavirus: What Every Medical Coder Needs to Know
On Dec. 31, 2019, as many of us here in the U.S. were celebrating New Year’s Eve, a pandemic quietly
Read more7 Top Tips for Mastering ICD-10-CM 7th Characters
Diagnosis coding brings the unique challenge of knowing when to use a 7th character on your ICD-10-CM code and then
Read moreTune Up Your Heart Knowledge in February
Since 1963, February has been “American Heart Month,” and the American Heart Association has been leading its awareness. The goal
Read moreWhat is Lobar Pneumonia?
Lobar pneumonia references a form of pneumonia that affects a specific lobe or lobes of the lung. This is a
Read moreCheck Your FESS Claims for Improper Payment Adjustments
MACs may be applying the multiple endoscopy rule incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the
Read moreOvercome Gender Identity Barriers in Healthcare
Part 3: Look out for insurance roadblocks and instill policies to ensure coverage for needed healthcare. Over the last couple
Read moreCoding Concussions
A concussion is a type of traumatic brain injury caused by a blow, bump, or jolt to the head or
Read moreGI Coding: Why Is Modifier 53 on the Medicare Physician Fee Schedule?
The Medicare Physician Fee Schedule (MPFS) includes special pricing for four colonoscopy codes when you append modifier 53 (Discontinued procedure).
Read moreUse New Vaping ICD-10-CM Code U07.0 Starting April 1, 2020
Diagnosis coding for vaping-related disorders has been a hot topic lately. It’s so hot, that you’re getting a new ICD-10-CM
Read moreYour Step-by-Step Guide to ICD-10-CM Coding of Orbital Fractures
ICD-10-CM 2020 added dozens of new codes for orbital fractures, which are breaks in the bones surrounding the eye. To
Read moreE/M 2021: Grasp the Future Roles of Time and MDM for Accurate Coding
Evaluation and management (E/M) code descriptors for office and other outpatient visits will look a lot different in the 2021
Read more99473 and 99474: Focus on 2020’s New Self-Measured BP Monitoring Codes
The clinical setting may not be the best place to get an accurate blood pressure reading, and two new CPT®
Read moreKnow What’s New in the 2020 Medicare NCCI Manual
Medicare has posted the 2020 National Correct Coding Initiative (NCCI) manual, with the updates helpfully marked in red, as usual.
Read moreTake the CPT® 2020 5-Question Challenge
January 1 is bringing roughly 400 CPT® code changes. See if you’re ready with this quick medical coding quiz, including
Read moreKnock Out Medical Claim Denials With This 1-2-3 Prevention Plan
If denial prevention is one of your New Year’s resolutions, we’ve got some ideas to help you achieve your goal.
Read moreWhat Does the 2020 MPFS Say About Nasal/Sinus Endoscopy Payment?
The 2020 Medicare Physician Fee Schedule (MPFS) final rule states Medicare will apply the special rule for multiple endoscopic procedures
Read morePart 3: Master Medicine Code Updates for CPT® 2020
A lot of specialties will find relevant updates in the Medicine section of CPT® 2020, and we’ve pulled together the
Read moreScary Good Advice for Medical Coders and Billers
October 1 is a scary time for medical coders. There are fourth quarter updates to HCPCS Level II codes and code
Read moree-Cig Users are Dying for a Specific Diagnosis
It’s important to code with specificity the use of e-cigarette products. Too bad the ICD-10-CM code set falls short in
Read morePart 2: Know What’s New in CPT® 2020 for Radiology and Path/Lab
You’ve gotten a glimpse at the new E/M and Surgery codes in Part 1 of our CPT® 2020 series. Now
Read moreTackling the Hepatitis C Epidemic
USPSTF drafts new HCV screening recommendations. New recommendations aim to curb the growing number of individuals infected with the hepatitis
Read moreI Am AAPC: Christiane M. Pokorny, COC, CPC
My mom’s advice to my sister and I growing up was to work in healthcare. She said it’s a great
Read moreIncrease Your Salary by 20 Percent
Earning an AAPC core certification (CPC, COC, CIC, CRC) opens the door into the medical coding world, but it doesn’t
Read moreUse 2020 ICD-10-CM Codes for More Specific Medical Data Capture
In a world of uncertainty, one thing medical coders can count on is ICD-10-CM yearly updates. It’s already that time
Read morePart 1: Prepare for CPT® 2020 for E/M and Surgery Codes
The 2020 CPT® code set includes 394 code changes, with 248 new codes, 71 deletions, and 75 revisions, according to
Read moreNew ICD-10-CM Code Rationales
Rationales for ICD-10-CM updates are key to improved medical coding, data reporting, and physician reimbursement. Many of the ICD-10-CM updates
Read more2019-2020 Influenza Vaccine Codes and Pricing
With schools and colleges back in session, you can only hope patients start coming in for their influenza vaccine, so
Read moreBreak Down the Barriers to Proper Fracture Coding
CPT® code selection comes down to knowing what to look for in the note and asking the right questions. Fractures
Read moreDecrease Payer Denials for Increased Revenue
Lower denial rates are key to turning around large healthcare organization payment issues. When you are a large organization, the
Read moreSelect the Right Episode of Care Every Time
Timing is everything when defining and capturing the 7th character in an ICD-10-CM code. ICD-10-CM brought about new concepts for
Read moreRealize the Value of Soft Skills in Healthcare
Do your healthcare workers have what it takes to excel in a consumer-driven marketplace? The landscape of healthcare organizations is
Read moreMaster E/M Coding and Earn CEUs
Are you looking for affordable continuing education units (CEUs)? We can do one better: Low-cost CEUs you can earn on
Read more2 Tips for Billing a Physician Assistant as Assistant Surgeon
A physician assistant (PA) serves as an assistant surgeon only to suture and close an incision. There is no documentation
Read moreWhat’s Proposed for MIPS in 2020 and What Are MVPs?
The Quality Payment Program (QPP) proposed rule for 2020 adds some insights into what we may see in 2021, as
Read moreCoding CAR T: Cancer Treatment Revolutionized
Now that revolutionary cancer therapy, Chimeric Antigen Receptor T-cell (CAR T-cell), is covered, let’s take a look coding CAR T. Last
Read moreAnesthesia Coders: Know How to Report for Multiple Procedures During Obstetric Cases
Obstetrical cases don’t always go as planned, so make sure you’re ready to report the correct anesthesia CPT® codes for
Read moreLearn Coronary Artery Anatomy According to CPT® and CCI
When your job is converting medical documentation into codes, your knowledge of medical anatomy has to be shipshape. But you’ve
Read moreWhat Happens When E/M Guidelines Change?
Medical coders, billers, auditors, and other healthcare business professionals started Day 2 of AAPC’s Regional Conference in New York City
Read moreAce ICD-10-CM Coding for Insect Bites, Poison Ivy, and Heatstroke
Know what to watch when coding bug bites, poison ivy, and heatstroke! Get ICD-10 pointers. Somehow it is mid-August already,
Read moreMedical Coders Convene in NYC for AAPC’s Regional Conference
They came to New York City from near and afar – medical coders, billers, auditors, practice managers, and all others
Read moreKnow When You Can — and Cannot — Waive Patient Copays
You may think you are doing your patients a favor when you write off their copays for your providers’ services.
Read moreTop 10 ICD-10-CM Official Guideline Updates for 2020
The FY2020 ICD-10-CM Official Guidelines for Coding and Reporting (OGs) are available now so you can prepare for the 2020
Read moreCatch Radiation and Home Visit Changes Coming Soon to Medicare Manual
Medicare has announced two updates to the Medicare Claims Processing Manual (MCPM). The implementation date is set for Aug. 27,
Read moreMore Changes Ahead for Evaluation and Management Services
Changes to payment, coding, and documentation policies for evaluation and management (E/M) services finalized in the 2019 Physician Fee Schedule (PFS)
Read moreGood Coding Habits for Sleep Medicine Begin with Simplification
You can rest assured that when you break procedurecodes into groups, it’s easier to compare and apply proper codes. Sleep
Read moreUse CARC and RARC to Improve Your Revenue Cycle
Learn how to speak the same language as your payer. Every part of the revenue cycle has an impact on
Read moreConsider Depth and Other Factors when Coding for Burns
The more familiar you are with burn injuries and documentation, the easier it is to code the cases. Burn coding
Read moreCMS Proposes Payment Changes to Endoscopic Sinus Codes
The Centers for Medicare & Medicaid Services (CMS) is proposing major payment changes to sinus endoscopy services. The 2020 Physician
Read moreAdd These AUC-Related Modifiers to Your Imaging Claims in 2020
At the end of July, Medicare released a set of modifiers that you need to know if you’re involved in
Read moreAdvanced Imaging Claims Require New Modifiers and G Codes
January 1, 2020, marks the start of the Appropriate Use Criteria (AUC) program educational and operations testing period, at which
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