Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
Moderate sedation coding, also sometimes referred to as conscious sedation, is a drug-induced depression of consciousness. A patient who has been sedated in this way is relaxed and generally insensitive to pain, but remains awake and able to respond to verbal instruction. If medically necessary and properly documented, moderate sedation is a separately reported service. […]
E&M code changes are expected to become effective in 2021. The American Medical Association (AMA) released on March 8 the summary of panel actions that took place at the February 2019 CPT® panel meeting. The exact wording is not considered to be finalized until just prior to the release of the following year’s code set. […]
The CPT® codes that are considered a laboratory test under the Clinical Laboratory Improvement Amendments (CLIA) change each year, as well as throughout the year, making it difficult for healthcare providers and laboratories to keep up. Here are the CPT codes for 2019 that are subject to or excluded from CLIA edits in easy-to-look up […]
The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during the same encounter? Did you consult […]
In addition to the annual release of CPT® code changes, the American Medical Association (AMA) likes to keep medical coders on their toes by releasing mid-year changes. The following Vaccine codes and Category III codes were accepted and/or revised at the September 2018 CPT Editorial Panel meeting for the 2020 CPT® production cycle. These codes are effective July […]
Lesion excision coding may seem complex, but reporting excision of benign (CPT Code 11400- CPT Code 11471) and malignant (11600-11646) skin lesions can be mastered in five steps. Step 1: Measure First, Cut Second: When assigning CPT® codes 11400-11646, you must know both the size of the lesion(s) excised and the width of the margins […]
New code changes number 335. The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019. There were many code revisions with guidelines, descriptions and instructional note changes. Let’s look at the highlights of many new CPT codes for 2019. There six new codes in the Evaluation and Management (E&M) […]