Category: Medical Coding

When To Report an Incidental Finding

When To Report an Incidental Finding

DOJ lawsuits may be your road map to risk adjustment compliance. The growing prevalence of risk adjustment in healthcare has forged new processes in documentation practices that have resulted in many organizations adopting practices that bend the cast iron rules for ICD-10-CM coding. We are starting to see some of the long-term dangers of ambitiously […]
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Understand Critical Care Before You Code

Understand Critical Care Before You Code

A solid understanding of guidelines and COVID-19-related complexities will limit claim denials and audits. Deciphering documentation to determine what qualifies as critical care services can be challenging for medical coders and auditors. With limited critical care codes available for assignment, reporting may appear relatively straightforward at first glance. However, there are many considerations that coders […]
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New COVID-19 ICD-10-CM and PCS Codes Coming in 2022

New COVID-19 ICD-10-CM and PCS Codes Coming in 2022

The package includes three ICD-10-CM and seven procedure codes. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have both stated that in April 2022, we will have three new ICD-10-CM codes and seven new procedure codes for COVID-19 therapeutics and vaccines. You may recall that in […]
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The Medical Coding News in November

The Medical Coding News in November

Take 5 to read up on recent coding and billing news. There are plenty of coding updates in November, including those made to certain Medicare policies. Payment thresholds for physical, occupational, and speech-language pathology are also posted for the 2022 calendar year, as are Medicare cost sharing amounts. And HCPCS Level II code set updates […]
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Resolve Initial vs. Subsequent Encounter Misconceptions

Resolve Initial vs. Subsequent Encounter Misconceptions

End the sequela struggle for when to include a 7th character with this primer. ICD-10-CM codes aren’t just for coding; they’re also used for payments, statistics, and other health information management activities. Therefore, some codes are designed to meet certain episode of care requirements that translate into costs. For example, a code describing an acute […]
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2021 E/M Guidelines FAQ – December

2021 E/M Guidelines FAQ – December

  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 Monthly and the Knowledge Center blog. In the May issue we started to answer your […]
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Master CPT 2022 Coding With This Expert Overview

Master CPT® 2022 Coding With This Expert Overview

The CPT® 2022 edition incorporates a total of 249 novel codes, along with 93 codes that have been revised, and 63 codes that have been removed. Every segment of the CPT® code set has undergone modifications to codes and guidelines. The most substantial revisions are observed in evaluation and management (E/M) codes, spine-related procedures such […]
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The CMS Expands Medicare Coverage for Remote Patient Monitoring

The CMS Expands Medicare Coverage for Remote Patient Monitoring

  CMS has been incrementally expanding coverage for remote patient monitoring since first recognizing the platform in 2019. Through RPM, healthcare providers can use digital health tools and telehealth platforms to improve care management for patients at home, especially those with chronic conditions or who’ve been recently discharged from a hospital. The platform has the […]
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New ICD-10-CM_PCS Codes Released

New ICD-10-CM/PCS Codes Released

The implementation of the new codes is April 1, 2022. The new ICD-10-CM/PCS codes for implementation on April 1, 2022, were recently released by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). The CMS v39.1 version of the MS-DRG grouper will be released in February 2022. […]
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