Tag: CPT Codes

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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Use 0074A for COVID-19 Pediatric Booster

Limit this code to administration of the Pfizer-BioNTech vaccine. On May 17, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to authorize the use of a booster dose for patients 5 through 11 years of age. The CPT® code to report administration of this […]
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Preventive Medicine Versus E&M Codes

Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to […]
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Preventing coding and billing errors can reduce claims denials

For primary care practices, earning enough revenue to meet overhead expenses and provide quality care has always been a challenge. But practices often make the challenge even greater through sloppy coding and billing, leading to delayed or incorrect reimbursements from payers. To see the entire video presentation, go here. INTRODUCTION For primary care practices, earning […]
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AMA announces CPT update for COVID-19 booster candidates

The American Medical Association (AMA) today announced an editorial update to Current Procedural Terminology (CPT®), the nation’s leading medical terminology code set for describing health care procedures and services, that includes newly assigned provisional CPT codes for COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline. The Pfizer booster candidate is proposed for use in children ages […]
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Barostim Heart Failure Treatment: Proper Procedural and Coding Training Ensure Accurate Reimbursement

  The Centers for Medicare & Medicaid Services (CMS) has begun covering a portion of the device cost for Barostim Neo, a neuromodulation device for treating chronic heart failure. In late 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin covering a substantial portion of the cost of implantable heart […]
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Confirm Dosage for New COVID-19 Booster

NDCs will help you determine when to use 0094A and 91309. If you’ve been waiting for news on Moderna’s booster dose-specific COVID-19 vaccine for adults, check this out: The Food and Drug Association (FDA) revised the emergency use authorization (EUA) to include this booster as of March 29, 2022. Assign 0094A, 91309 for Booster Dose […]
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Payer Strategies and the Long Road to Payment

The average cost of debunking a denial is $25 per claim, not to mention the continuous challenges associated with attaining timely payment. Reviewing denial management strategies on a regular basis may prove a more efficient payment journey. Claim denials are a continuous challenge for the healthcare industry, as providers struggle with write-offs and the resources […]
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Professional, Hospital E/M Charge Index Continued to Grow in 2021

In addition to the hospital E/M charge index rising, prices for professional evaluation and management, surgery, medicine, and radiology services increased last year. The median charge index for hospital evaluation and management (E/M) visits increased by 7 percent during the COVID-19 pandemic, according to a white paper from FAIR Health. The FH Medical Price Index […]
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