Category: Medical Coding

E_M Coding Guidelines Could Ease Physicians’ Documentation Burdens

How 2021 E/M Coding Guidelines Could Ease Physicians’ Documentation Burdens

Physicians will potentially have a lighter documentation burden and more time to spend with patients in 2021 thanks to an overhaul of Medicare Coding guidelines for outpatient evaluation and management (E/M) services. “The whole point was to have people not document stuff that was not necessary, not relevant to the clinical management of the patient,” […]
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FESS Codes Claims for Improper Payment Adjustments

Check Your FESS Codes Claims for Improper Payment Adjustments

MACs may be applying the multiple endoscopy rules incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple endoscopic procedures to the family of functional endoscopic sinus surgery (FESS) codes. Practices are now getting remittance advice […]
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Deep-Tissue Pressure Injury

The Dilemma of Coding and Reporting Deep-Tissue Pressure Injury

Confusion and apprehension surround new guidelines for deep-tissue pressure injury. The release of the 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage, or deep-tissue pressure injury (L89.-6). The ambiguity stems from what […]
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Radiology Code Update

Radiology Code Update for 2020

Quite a few code changes and revisions were made to the Radiology Code section of CPT Code for 2020. Less confusing language and expanded code categories will make life easier for medical coders. Here’s a quick review. Gastrointestinal System A mini overhaul of the gastrointestinal system codes removed the confusing language of “with or without […]
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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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