Category: Medical Coding

New Patient EM Denials

New Patient E/M Denials: Mystery Solved

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
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10 Tips To Prepare Practices For E/M Office Visit Codes Changes

The Centers for Medicare and Medicaid Services has taken steps to overhaul codes used for Evaluation and Management (EM) office visit codes. The initiative aims to reduce documentation burdens that interfere with patient care, the American Medical Association says. The professional organization for the nation’s physicians is providing a series of educational materials to support […]
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4 Steps for Improved Excision Coding

4 Steps for Improved Excision Coding

Consideration of several factors, such as the type of removal, lesion size and location, pathologic results, intent, etc., is key to accurately coding dermatological lesion removal procedures. Let’s review the codes and guidelines for lesion removal by excision and how to avoid common mistakes when coding these skin procedures. Excision – Benign/Malignant Lesions (11400-11646) Excision […]
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Deciphering the CPT Code Changes

Deciphering the CPT Code Changes

The American Medical Association (AMA) publishes the Current Procedural Terminology code set changes every year, usually in September, for the upcoming new year. The changes impacting CPT 2020 were released on September 4, 2019. There was a total of 394 CPT code changes, of which, 58 affect the surgery center market. 2020 CPT Code Changes […]
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New Code for E-Cigarette Associated Lung Injury

New Code for E-Cigarette/Vaping Associated Lung Injury (EVALI Code)

Emergency release of the new EVALI code by CDC. On Dec. 9, 2019, the Centers for Disease Control and Prevention (CDC) published additional guidance regarding e-cigarette/vaping associated lung injury (EVALI Code). The new code is U07.0 (Vaping-related disorder). The CDC consulted with the World Health Organization (WHO) regarding an addition to the classification that would […]
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AI Can Help Health Plans Become Member-Centric

How AI Can Help Health Plans Become Member-Centric

Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
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