Tag: American Medical Association

Prior Authorization Reform Rule Proposals

CMS Unveils Contentious Prior Authorization Reform Rule Proposals

Physicians and healthcare experts are urging Medicare to lead reforms in the time-consuming prior authorization (PA) process, which often causes delays in patient care. However, they caution against excessive reform, as it could exacerbate the problem rather than improving it. The U.S. Centers for Medicare and Medicaid Services (CMS) have put forth two proposals for […]
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COVID-19 Codes Brought Multitude of Post-Acute Conditions

The spotlight is on your revenue cycle’s coding team as COVID-19 reporting sheds light on a multitude of post-acute conditions brought on by the virus. A recent study published in the Journal of the American Medical Association Network Open found that between October 1, 2021, and January 31, 2022, providers used ICD-10-CM code U09.9 (post-COVID-19 […]
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The Past, Present, and Future of E&M Services

Providers are currently stuck with outdated templates, leaving plenty of room for improvement. I thought it might be appropriate to take a “four score and seven years ago” look across evaluation and management (E&M) services, looking at what we had, what we have, and what is still to come. So, to begin, I will rewind […]
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AMA Announces CPT Code for Moderna COVID-19 Vaccine for Young Kids

While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a CPT code to ensure healthcare professionals are prepared for the shot’s potential use. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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CPT Code Set Adds Code for J&J COVID-19 Vaccine Booster

AMA updated the CPT code set to accommodate the new mix-and-match COVID-19 vaccine booster strategy endorsed by the federal government. The update comes on the heels of a decision from the Federal Drug Administration (FDA) to authorize booster doses of Janssen’s COVID-19 vaccine. The federal agency has recommended a booster dose of the vaccine for […]
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Health Insurance Industry Consolidation Grew from 2014 to 2020

Health insurance industry consolidation continued to increase, restricting consumers’ options for coverage, an American Medical Association report argued. “As merger rumors involving health insurers swirl, the prospect of future consolidation in the health insurance industry should be more closely scrutinized given the low levels of competition in most health insurance markets,” Gerald E. Harmon, MD, […]
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AMA Updates CPT Codes for COVID-19 Vaccines

The updates include unique CPT codes for a new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses expected to roll out later this month. The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster […]
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AMA Finalizes CPT Codes for Third Doses of Moderna, Pfizer Vaccines

AMA announced that the CPT codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are finalized and ready for the upcoming booster shot administrations. The American Medical Association (AMA) announced that the Current Procedural Terminology (CPT) codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are effective for immediate […]
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