Tag: CPT Codes

Use 0074A for COVID-19 Pediatric Booster

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

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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AMA announces CPT update for COVID-19 booster candidates

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: Coding Training

Barostim Heart Failure Treatment: Coding Training

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 failure […]
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Confirm Dosage for New COVID-19 Booster

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

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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Key Factors When Coding Drug Screenings

Key Factors When Coding Drug Screenings

Dodge denials for drug testing by knowing which details demand attention. How often do you experience denials when it comes to your definitive drug testing? If the answer is often, this article may provide some answers to why that might be happening. Many payer policies have very clear guidelines, both medical and reimbursement, that dictate […]
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New codes in 2022 for principal care and chronic care management services

New codes in 2022 for principal care and chronic care management services

There are three new codes in the care management section of the CPT codebook, covering principal care management and chronic care management services. Here’s what physicians need to know about them. Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” These codes are like chronic care […]
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