Category: Blog

E_M Coding for 2021_ What’s New and Different

E/M Coding for 2021: What’s New and Different

After three years of policy proposals, the American Medical Association Current Procedural Terminology (CPT) panel responses, and substantial guidance from gastroenterology and other specialty societies, changes to the office/outpatient evaluation and management (E/M) codes became effective as of January 2021. Some aspects of these revisions took effect for telehealth services since spring 2020 for Medicare, […]
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CMS Releases 2022 Proposed Inpatient Prospective Payment System Rules

CMS Releases 2022 Proposed Inpatient Prospective Payment System Rules

On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The proposed rule includes CMS proposals for certain annual Medicare payment policies and rates as well as certain quality and value-based programs for FY 2022. Stakeholders must submit […]
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Hiding Data_ Hospitals Fail to Comply with Price Transparency Requirements

Hiding Data: Hospitals Fail to Comply with Price Transparency Requirements

At first glance, it appeared that hospitals were complying with the Centers for Medicare & Medicaid Services’ (CMS) price transparency requirement, which became effective January 1, 2021. Upon a closer look; however, multiple deficiencies were found. CMS previously advised that it would begin auditing compliance with the rule this past January. Interestingly, it was the […]
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CPT Coding For Excisional Wound Debridement With VAC

CPT Coding For Excisional Wound Debridement With VAC

Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2×4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)? A: The debridement would be reported using CPT code 11042 (debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq cm or less). This procedure […]
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