Month: October 2020

Updates on COVID-19 Billing and CS Modifier Audits

Updates on COVID-19 Billing and CS Modifier Audits

The pandemic continues to impact Medicare reimbursement. COVID-19 continues to make news on the regulatory front with two new directives from the Centers for Medicare & Medicaid Services (CMS), centering on testing for the deadly coronavirus and formal coding edits for the Medicare Administrative Contractors (MACs) on payments with the CS modifier. There’s a new […]
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ICD-10 Coding Guideline Changes

ICD-10 Coding Guideline Changes

For 2021, there are 490 new, 47 revised and 58 deleted ICD-10-CM codes. We will cover the ICD-10-CM guidelines in this article and the ICD-10-CM code changes next month. There are several important changes to the guidelines, including those relating to COVID-19 coding. The updates for these were a little late this year due to […]
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CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth services cover some cardiac and pulmonary rehabilitation services, as well as certain neurostimulator analysis and programming services. The additions to the Medicare telehealth list were made in […]
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E/M Changes Take Effect January 2021

  Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of […]
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The Need for Facility Coding Guidelines

The Need for Facility Coding Guidelines

Facility-specific coding guidelines are key to code hospital visits and encounters consistently. Another role that facility-specific guidelines play is to capture all possible reimbursement that is due to an organization. Every Oct. 1, the MS-DRGs and ICD-10-CM/PCS are updated. In addition to the MS-DRGs, the New Technology Add-On Payments (NTAPs) are updated as well. It […]
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New CPT Codes for Multi-Virus Tests Detect COVID-19 and Flu

New CPT Codes for Multi-Virus Tests Detect COVID-19 and Flu

The American Medical Association (AMA) today published an update to the Current Procedural Terminology (CPT®) code set that includes new code additions and editorial revisions for reporting medical services sparked by the public health response to the COVID-19 pandemic. The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened […]
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AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

The American Medical Association updated its Current Procedural Terminology set to include updates to coding for tests that detect influenza and COVID-19. The two new codes, per the AMA’s CPT editorial panel, are: 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A […]
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Sequence ICD-10-CM Codes for Proper Payment

Key Concepts for Determining Primary Diagnosis Codes

Accurate diagnosis coding is crucial for medical billing, as it narrates the patient’s healthcare journey. Patients often present with multiple conditions, requiring coders to select and sequence the most specific codes. This sequencing, or code arrangement, is vital for correct billing. This discussion highlights five key terms from the ICD-10-CM Official Guidelines for Coding and […]
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ICD-10 Coding Tips for Influenza

ICD-10 Coding Tips for Influenza

There has been much discussion about COVID-19 this year, but as autumn approaches, thoughts turn towards influenza season. The Advisory Committee on Immunization Policies (ACIP) recently published guidelines for flu vaccination. Their advice is that routine annual vaccination is recommended for everyone 6 months of age and older. The United States vaccines will include updates […]
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