Category: Medical Coding

Optimizing Debridement Coding: Tips for Accurate Claims and Payments

Optimizing Debridement Coding: Tips for Accurate Claims and Payments

The growing U.S. wound care market, fueled by an aging population and rising rates of chronic conditions, presents significant opportunities for healthcare providers. Accurate debridement coding is essential to maximize reimbursement and optimize patient care. Pressure injuries alone affect around 2.5 million Americans each year, leading to more than 60,000 deaths and costing between $9.1 […]
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How to Use Modifiers 59 and X[ESPU] to Maximize Reimbursement

How to Use Modifiers 59 and X[ESPU] to Maximize Reimbursement

When you bill for distinct, separate procedures, it’s crucial to know which modifiers will ensure full payment for each service. Modifier 59, “Distinct Procedural Service,” acts as a universal tool to unbundle procedures that are typically included in a larger procedure or “bundled” together. This modifier signals to the payer that specific circumstances justify separate […]
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funniest ICD-10 codes for Halloween

The Funniest ICD-10 Codes for Halloween 2024

Halloween is a time for fun, frights, and… the funniest ICD-10 codes for Halloween? Yes, you read that right! The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a complex system used to classify diseases and injuries. While it’s a serious tool for healthcare professionals, some of its codes can be quite amusing, […]
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Healthcare fraud in medical coding

Healthcare Fraud in Medical Coding: Upcoding, Unbundling, and Emerging Challenges

Healthcare fraud in medical coding, particularly through practices like upcoding and unbundling, has become a major concern for medical coding and billing professionals. A recent healthcare market research survey found that 90% of respondents view upcoding as a significant ethical challenge Upcoding involves assigning higher-level codes to medical services than are warranted, leading to inflated […]
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ICD-10-CM & PCS Code Changes Every Medical Coder Needs to Know

ICD-10-CM & PCS Code Changes Every Medical Coder Needs to Know

The recent ICD-10-CM and PCS code updates, let’s delve into a mixed bag of relevant topics. One significant change allows us to assign severity levels for certain eating disorder diagnoses. For anorexia nervosa (both restricting and binge eating/purging types), bulimia nervosa, and binge eating disorder, we can now specify the following severity levels: Mild Moderate […]
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You need to know about 99211 CPT code: Guide

Navigating the intricate landscape of medical billing and coding demands a firm grasp of Current Procedural Terminology (CPT) codes. One of the most commonly used yet frequently misunderstood codes is CPT 99211. This low-level evaluation and management (E/M) code is employed for services rendered by healthcare providers, typically in outpatient settings. While it might appear […]
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ICD-10 Codes Related to Natural Disasters

The International Classification of Diseases, 10th Revision (ICD-10), is a standardized medical classification system developed by the World Health Organization (WHO). It categorizes diseases, injuries, and other health conditions, including ICD-10 Codes for Natural Disasters. For natural disasters, the ICD-10 provides specific codes to classify related injuries and health issues. Here are some of the […]
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Spinal neurostimulator implantations

CMS Prior Authorization for Spinal Neurostimulator Procedures

Prior Authorization for Spinal Neurostimulator Implantations: The Centers for Medicare & Medicaid Services (CMS) implemented a prior authorization requirement for spinal neurostimulator implantations surgeries on July 1, 2021. This policy change took effect after the Office of Inspector General (OIG) had concluded its field work but before the release of its investigation report. CMS specifically […]
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2024 Comprehensive Cardiology ICD 10 Codes for Healthcare Professionals

Here’s an extensive table of cardiology ICD 10 codes tailored for utilization by cardiology specialists, researchers, and healthcare practitioners such as nurses, medical coders, and physicians. This curated table encompasses relevant 2024 cardiology ICD 10 codes and classifications specifically focused on cardiovascular conditions. Contained herein are cardiology ICD 10 codes covering a wide range of […]
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