Category: Medical Coding

AMA Announces Update to COVID-19 Vaccine CPT Codes

AMA Announces Update to COVID-19 Vaccine CPT Codes

The American Medical Association (AMA) today announced that the Current Procedural Terminology (CPT®) code set is being updated by the CPT Editorial Panel to include vaccine and administration codes that are unique to the COVID-19 vaccine candidate under development by Janssen Pharmaceutica, a division of Johnson & Johnson. The new CPT codes will be effective for use […]
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2021 ICD-10-CM Coding Guidelines Get a Refresh

2021 ICD-10-CM Coding Guidelines Get a Refresh

Several changes have been recently made to the ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year (FY) 2021. The guidelines changes affect code assignment for conditions and symptoms related to COVID-19. The Centers for Medicare & Medicaid Services (CMS) released the updates in December 2020. Familiarize yourself with the following new and revised guidance to […]
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New COVID-19-Related ICD-10-CM Codes Take Effect

New COVID-19-Related ICD-10-CM Codes Take Effect

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) broke from the usual release schedule and implemented the following six new codes related to COVID-19 on Jan. 1 and issued accompanying guidelines. Z20.822 Contact with and (suspected) exposure to COVID-19 For asymptomatic individuals with actual or suspected exposure to COVID-19, assign code Z20.822. For symptomatic […]
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CMS Recalculates Medicare Physician Fee Schedule Rates for 2021

CMS Recalculates Medicare Physician Fee Schedule Rates for 2021

CMS has updated Medicare Physician Fee Schedule rates for 2021 after a COVID-19 stimulus package mitigated budget neutrality cuts finalized in a December rule. The Consolidated Appropriations Act, 2021 passed by Congress on Dec. 21, 2020, enacted a 3.75 percent increase in Physician Fee Schedule payments for all providers in 2021 to “support physicians and other professionals in adjusting to […]
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Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
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Top Error Rates Offer Clues to Denials

Top Error Rates Offer Clues to Denials

The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
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6 Questions Ensure E_M Compliance

6 Questions Ensure E/M Compliance

Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
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CPT 2021 Update_ New Lab, Category III Codes

CPT® 2021 Code Updates: Second and Third Quarters

The American Medical Association (AMA) has released updates for the second and third quarters of CPT® 2021. These changes, including new, revised, and deleted codes, will be implemented in AAPC’s Codify system as they become effective. Practices should also update their CPT® 2021 code books and electronic health record (EHR) software accordingly. Proprietary Laboratory Analyses […]
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A Glance at 2021 Evaluation and Management Changes

A Glance at 2021 Evaluation and Management Changes

The evaluation and management (E/M) changes for calendar year 2021 are the result of a collaborative effort between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). CMS first addressed the changes in the 2020 Medicare Physician Fee Schedule Final Rule, in which CMS indicated that it planned on adopting […]
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