Tag: CPT Codes

AMA Issues More COVID-19 Vaccine Codes

AMA Issues More COVID-19 Vaccine Codes

 The American Medical Association’s (AMA’s) CPT® Editorial Panel has released eight new COVID-19-related codes to report a new formulation of the Pfizer vaccine, a Moderna booster vaccine, and a Pfizer booster using either the new or old formulation. These codes are in addition to the four new CPT codes released last month and the many […]
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Gain Insight Into Billing an E/M With OMT

Gain Insight Into Billing an E/M With OMT

Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
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Medical Coding News – August 2021

Medical Coding News – August 2021

  What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II codes for COVID-19 therapeutic injections; and Medicare payment allowances for the 2021-22 influenza vaccine codes have been released. FDA Approves COVID-19 Vaccine Pfizer’s COVID-19 vaccine received the […]
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Prolonged Services in CPT versus Medicare

Prolonged Services in CPT versus Medicare

The code 99417 is invalid for Medicare and MA reimbursement. When the CPT® Guidelines were updated for 2021, one of the options for leveling an office or other outpatient evaluation and management (E&M) service was to use time as the leveling agent. The time thresholds for each E&M office visit were also changed from “typical” […]
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Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
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CMS Releases New ICD-10-PCS Codes for COVID-19

CMS Releases New ICD-10-PCS Codes for COVID-19

New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021. The procedure codes introduce six specific medications that can be used for treatment of COVID-19. The drugs […]
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AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

The American Medical Association updated its Current Procedural Terminology set to include updates to coding for tests that detect influenza and COVID-19. The two new codes, per the AMA’s CPT editorial panel, are: 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A […]
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AMA Approves 2 New CPT Codes for COVID-19

AMA Approves 2 New CPT Codes for COVID-19

One of the codes, CPT Code 99072, is for reporting additional supplies used to mitigate spread of the virus. The American Medical Association (AMA) announced, Sept. 8, two new Category I CPT® codes to meet the changing needs of the healthcare industry brought about by the COVID-19 public health emergency (PHE). The codes were approved […]
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2021 E_M Guideline and Leveling Changes

2021 E/M Guideline and Leveling Changes

Providers need a mechanism to be accurately reimbursed for the time and effort that they expend in providing care. Evaluation and Management (E/M) leveling has been the standard method in which to provide appropriate, defensible payments for services. However, it has been successfully argued that the 1995 and 1997 E/M guidelines in place today are […]
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