Category: Medical Coding

CPT Updates

CPT Code Updates: Radiology, Emergency Medicine, and Behavioral Health Changes

Upcoming changes to the CPT code set include updates to radiology and medicine sections, effective for claims submitted on or after January 1. Radiology Updates Several radiology codes have been revised, added, or deleted: Revised Radiology Codes: 74022, 74210, 74220, 74230, 74240, 74246, 74250, 74270, 74280 New Radiology Codes: 74221 – Esophagus radiologic exam, double-contrast […]
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Preparing for ICD-11

HCC Coding: Preparing for ICD-11

HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are HCC coding for hierarchical condition category (HCC) purposes, you know that HCCs are categories of related ICD-10 codes. Only selected significant conditions to drive a payment HCC coding. That means only conditions that […]
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Chiropractic Code Changes

Chiropractic Code Changes For 2020

You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
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Medicare Reimbursement Rates for Kidney Care-1

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
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Check NCDs for ICD-10-CM Diagnosis Code Updates

Check NCDs for ICD-10-CM Diagnosis Code Updates

Changes to ICD-10-CM Diagnosis Code mean NCD coding changes. ICD-10-CM Diagnosis Code changes went into effect Oct. 1, as usual, and the Centers for Medicare & Medicaid Services (CMS) is updating National Coverage Determinations (NCDs) to reflect those changes. NCDs Affected by Updates to ICD-10-CM Diagnosis Code CMS notes the following NCD coding changes in […]
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Final Physician Payment Rule Keeps EM Code Changes

Medicare Remote Patient Monitoring: CMS Finalizes New Code and General Supervision

CMS just released the 2020 final rule with changes to remote patient monitoring (RPM), officially titled “Chronic Care Remote Physiologic Monitoring,” reimbursed under the Medicare program, as part of the Physician Fee Schedule changes. The changes, proposed earlier this year, have been hotly-anticipated by digital health companies hoping to see more clarity and flexibility for RPM services. CMS […]
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Outpatient Proposals

2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
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