Therapy Threshold Amounts for 2021
Know your modifier KX rules to ensure payment. The annual update to the threshold amounts for physical therapy, speech-language pathology,
Read moreKnow your modifier KX rules to ensure payment. The annual update to the threshold amounts for physical therapy, speech-language pathology,
Read moreSeveral changes have been recently made to the ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year (FY) 2021.
Read more0640T Noncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation
Read moreThe answers to three frequently asked questions may surprise you. Here are three frequently asked questions (FAQs) about vaccination coding
Read moreVisionaries predict the role of the medical coder will change. Here’s what you need to know to secure your place
Read moreTake a look, from an auditor’s perspective, at using MDM to code office visits in 2021. When training providers on
Read moreLook to the ICD-10-CM guidelines for accurate selection and sequencing of diagnosis codes for diabetes. Diabetes mellitus (DM) is a
Read moreUse CERT program reports to improve proper payment rates for Medicare claims. The Comprehensive Error Rate Testing (CERT) program grew
Read moreThe 2021 OPPS final rule seeks to increase patient choice and lower out-of-pocket costs. On Dec. 2, 2020, the Centers
Read moreA $1.4 trillion government spending bill and $900 billion COVID-19 relief package is on its way to the White House.
Read moreIn a final rule, CMS expands telehealth coverage but enforces budget neutrality mandate. After a slight delay, the Centers for
Read moreCMS continues to phase in the Quality Payment Program while MACRA mandates loom. The long-awaited Physician Fee Schedule (PFS) final
Read moreMedicare issues two codes for second COVID-19 antibody therapy. A new investigational monoclonal antibody therapy for Medicare patients with mild
Read moreLatest update includes assignments for new COVID-19-related diagnoses and procedures. The ICD-10 Medicare Severity-Diagnosis Related Group (MS-DRG) V38.1 Grouper Software,
Read moreAccurate ICD-10-CM reporting starts with understanding seasonal affective disorder. December is Seasonal Depression Awareness Month, and for good reason: In
Read moreTake your coding to a whole new level by getting more done in less time. Coding professionals face a new
Read moreHere’s how to report a trio of PM needle procedures. Pain management (PM) practices see a revolving door of patients
Read moreAccurate coding and proper reimbursement hinge on understanding modifier usage. When I began my coding career in 2002, I was
Read moreGain perspective as several men reflect on working in a female-dominated field. Medical coding is a rewarding field, as evidenced
Read moreFamiliarize yourself with CPT® guidelines to ensure proper coding and payment of evaluation and management services. Although evaluation and management
Read moreDenials resolution is a natural step up the career ladder for medical coders. As inpatient coders, we often are asked
Read moreMake your New Year’s resolution to reduce your error rate. Medical coding and billing errors can cause a host of
Read moreJust in time for new COVID-19 vaccine, administration, and treatment codes. The government is working at warp speed to make
Read moreRevised instructions indicate payment status for new CPT codes. The Centers for Medicare & Medicaid Services (CMS) has issued changes
Read moreProper claims payment is certain when you map out the best route. Coding coronary artery bypass graft (CABG) surgery is
Read moreMake sure you’re not missing any diagnoses that will better portray patient risk to your payer. Diabetes causes elevated blood
Read moreEnsure compliance and proper reimbursement using this guide to coding discontinued inpatient procedures. In the inpatient coding world, a great
Read moreStomach the coming coding changes to evaluation and management services with this primer. By now, everyone knows of the seismic
Read moreBecome a modifier expert by looking at the numbers. Pop quiz: A patient is admitted to the hospital. The provider
Read moreLabs soon will have to work harder to merit the maximum allowed Medicare payment for high-throughput tests used to detect
Read moreThe Appropriate Use Criteria (AUC) program, slated to begin Jan. 1, 2021, has been postponed. A notice on the Centers
Read morePhysicians can now offer more services via telehealth and get paid. The Centers for Medicare & Medicaid Services (CMS) is
Read moreModifiers 26 and TC are unique coding tools that may be used in specific circumstances. It can be easy to
Read moreMandatory model aims to reduce Medicare expenditures for ESRD patients while improving their quality of care. Medicare beneficiaries suffering with
Read moreThe latest changes to the CPT® code set will help clinicians distinguish seasonal infections from COVID-19 in their reporting. Three
Read moreUnless ordered otherwise, most commercial payers will return to business as usual Jan. 1, or sooner. The COVID-19 public health
Read moreBreast Cancer Awareness month is the perfect time to review your practice’s medical coding for preventive and diagnostic breast imaging.
Read moreBolster your clinical coding by understanding the differences between syndromes, disorders, and diseases. While most people are familiar with the
Read moreOpportunity is knocking for medical coders who want to transition into a new role. What is CDI? Clinical documentation improvement,
Read moreHere’s what you need to know to stay ahead of the curve and master hospital outpatient billing. When discussing the
Read moreFor a code that has no relative value units (RVUs) and commands $0.00 in Medicare nonfacility fees, 99000 Handling and/or
Read moreOne of the codes, 99072, is for reporting additional supplies used to mitigate spread of the virus. The American Medical
Read moreMaintain your certifications without spending a dime. You passed your credential exam and now you have the responsibility of maintaining
Read moreOver the past several months, as the COVID-19 pandemic has raged on, the American Medical Association (AMA) has expedited the
Read moreThe updated code set includes E/M code revisions and more. Here’s a preview. Medical coders will get a bit of
Read moreIt’s clear now which services apply to the no cost-sharing waiver. The Centers for Medicare & Medicaid Services (CMS) recently
Read moreThree years is your key. Selecting the correct code for many evaluation and management (E/M) services (outpatient visits and rest
Read moreEnsure your provider’s cataract surgery documentation is audit-proof. Are the documentation requirements for cataract surgery in adults a little fuzzy?
Read moreFamiliarize yourself with the 2020 code changes for long-term electroencephalograph recording. Auditing medical claims for long-term electroencephalograph (EEG) and video
Read moreMake sure your diagnosis coding is up to date by reviewingthis chapter-by-chapter summary of the changes effective October 1. The
Read moreReview the new and revised guidelines for coding and reporting diseases such as COVID-19. While the ICD-10-CM code changes for
Read moreWith the novel coronavirus continuing to circulate and cause severe illness in the United States and worldwide, getting a flu
Read morePhysician Fee Schedule proposed rule lays the groundwork for payment and policy changes. The Centers for Medicare & Medicaid Services
Read moreAnd that’s not all: CMS has issued new coding guidance, too. The Centers for Medicare & Medicaid Services (CMS) implemented
Read moreICD-10-CM coding is clear when you know what to look for. Children’s Eye Health and Safety Month is a good
Read moreAugust is Children’s Eye Health and Safety Month. With the upcoming school year just around the corner, August is dedicated
Read moreKnow what details you need to piece together for proper coding of percutaneous coronary intervention. Percutaneous coronary intervention (PCI) coding
Read moreExpand your knowledge and boost your career with AAPC’s newest advanced specialty course. In this ever-evolving healthcare environment, employers need
Read moreHow to understand and deal with MIS-C and the unknown. As if the threat of COVID-19 wasn’t enough, at the
Read moreI graduated with a Bachelor of Arts degree in Cuba, and I taught at a university there. When I emigrated
Read morePart 2: Learn the key to developing a plan for ICD-11 implementation. Starting Jan. 1, 2022, countries around the world
Read moreHere’s why you shouldn’t use these codes for physician services … ever. There’s a slew of new health behavior assessment
Read morePayers are reimbursing providers for all COVID-19-related testing and treatment they are furnishing to their insured members, but what if
Read moreThere are a slew of changes and only a few months before you will need to start using the new
Read moreThe Centers for Medicare & Medicaid Services (CMS) released the July 2020 update of the Ambulatory Surgical Center Payment System
Read moreFamiliarize yourself with the 2020 CPT® code updates for the cardiovascular system using this simplified guide. During these uncertain times,
Read moreResearch is a big job market often overlooked by healthcare business professionals. Healthcare is changing rapidly. New technology and drugs
Read moreJuly brings awareness to juvenile arthritis: Learn about it to ensure proper diagnosis coding. When people hear that someone has
Read morePart 1: Insight into the history of ICD and how it has changed over time is key to developing a
Read moreJust when you thought you had all the COVID-19 coding for laboratory testing figured out — hold the phone —
Read moreKnow how to find the answer and improve your clean claims rate. Medicare revises its National Correct Coding Initiative (NCCI)
Read moreSeveral procedure-to-procedure (PTP) edit changes in the Medicare National Correct Coding Initiative (NCCI) database will go into effect July 1.
Read moreThe 2021 ICD-10-PCS files are now available. Inpatient coders will have 544 new codes to work with beginning Oct. 1,
Read moreC1748 Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable) C1849 Skin substitute, synthetic, resorbable, per square centimeter C9059 Injection,
Read moreUpdate your understanding of how to code telehealth services now and in the future. Disclaimer: At press time, this information
Read moreCompliant reporting of myocardial infarction revascularization procedures is all in the timing. Does your staff know the coding guidelines for
Read moreCapture risk adjustment payment for physicians who treat patients with late effects of sepsis. In the United States, more than
Read more7 steps to set you down the path to coding claims with certainty. It has been my experience — both
Read moreProper coding requires medical coders to know the difference. June is when we wear purple to recognize Alzheimer’s and Brain
Read moreAs the global pandemic enters its fifth month, we are all feeling the strain. Staying home to slow the spread
Read more2020 has proven to be one of the most complex, busiest times in healthcare — in the 21st century, anyway.
Read moreEver since the publication of the Office of Inspector General’s (OIG’s) portfolio “Medicare Needs Better Controls to Prevent Fraud, Waste,
Read moreHealthcare providers are granted even more latitude for use of telehealth services during the COVID-19 public health emergency. When attending
Read moreTips to improve and streamline your stroke diagnosis coding processes. There are a lot of variables at play when it
Read moreBecome a coding superhero with X-ray vision. When is imaging separately reported, and how? The relative value units (RVUs) for
Read moreWeigh the pros and cons as the healthcare industry prepares to implement new leveling guidelines. Unless you’ve been hiding under
Read moreHeightened documentation requirements and new technology require us to see the flaws in our EMRs and correct them. I’ve been
Read moreCapture full payment for remote visits during the PHE for COVID-19. An interim final rule published in the April 6,
Read moreIf you find yourself struggling to rapidly adjust to the ever-changing environment of the COVID-19 pandemic, you are not alone.
Read moreThe Centers for Medicare & Medicaid Services (CMS) created two new HCPCS Level II codes for lab tests that use
Read moreDuring an emergency meeting in response to the COVID-19 crisis, the American Medical Association (AMA) convened the CPT® Editorial Panel
Read moreThe implementation of the Families First Coronavirus Response Act waives cost-sharing (coinsurance and deductibles) for COVID-19 testing-related services. The Act is
Read moreClinical diagnostic laboratories can identify specimen collection for COVID-19 testing using two new HCPCS Level II codes, effective March 1,
Read moreOn April 1, 2020, the National Center for Health Statistics (NCHS) formally issued updates to the ICD-10-CM List of Diseases
Read moreSpecificity will help your inpatient rehab facility meet the 60 percent rule. The opioid crisis has drawn a lot of
Read moreUnderstand the coding mechanics behind some of the most common obstetrical US examinations. An outsider looking in might think diagnostic
Read morePrepare for the unexpected when the patient is expecting. Oh, those cute little babies! All those fingers and toes and
Read moreThere’s a diagnosis code for every springtime affliction you can think of. Spring fever is not a definitive diagnosis in
Read moreDeficient understanding of this essential vitamin could wreak havoc on your coding for related testing and diagnoses. Vitamin D testing
Read moreWorking from home isn’t for everyone. Consider the pros and cons. Working from home can be a dream come true
Read more