Category: Medical Coding

CMS Updates HCPCS Level II for Q2

CMS Updates HCPCS Level II for Q2

Medical Coding Updates and Insights Unveiled Effective April 1, 2022, the HCPCS Level II code set, which is employed to record medical services and provisions, will encompass the integration of 37 novel codes. Furthermore, the second quarter revision encompasses the elimination of five codes and a refinement of the description for one modifier. Lay Terms […]
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New codes in 2022 for principal care and chronic care management services

New codes in 2022 for principal care and chronic care management services

There are three new codes in the care management section of the CPT codebook, covering principal care management and chronic care management services. Here’s what physicians need to know about them. Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” These codes are like chronic care […]
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Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

The heart of the principal diagnosis selection is pivotal to accuracy and compliance. Since February is known as “National Heart Month,” a discussion on the heart of inpatient coding is appropriate, that being the “principal diagnosis.” When learning inpatient coding, a large amount of time is spent on understanding the guidelines, conventions, and application of […]
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Medical decision making and coding

Medical decision making and coding

MDM elements during a preventive visit Q: Is it appropriate to count laboratory tests and other tests ordered during a preventive medicine service (99381-99397) visit in medical decision making (MDM) selection? No, because the 2021 revisions to the E/M office or other outpatient MDM do not apply to codes 99381-99397 (preventive services). These codes are […]
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Health Equity and SDOH: A Payer Perspective / Update

Health Equity and SDOH: A Payer Perspective / Update

As part of its ongoing mission to improve the health of America, the Blue Cross Blue Shield Association (BCBSA) announced its National Health Equity Strategy in April 2021 to confront the nation’s crisis in racial health disparities. This strategy is intended to change the trajectory of health disparities and reimagine a more equitable health care […]
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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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