Tag: CPT Coding

When to Use Modifiers 52, 73, 74

Demystifying Facility Coding

Modifiers 52: Professional fee-for-service guidelines for modifiers do not apply in the clinical setting. Reduced, Failed, Aborted, Aborted… which one? What are the requirements for using modifiers 52, 73 and 74? These questions are common in the coding center world, and  the answers  never seem to be clear. Confusingly mix up the medical code instructions […]
Learn More
Compliance in medical coding

Navigating Regulatory Compliance in Medical Coding for Accurate Billing

Explore the intricacies of codes for a better understanding of regulatory compliance in medical coding. Healthcare billing and documentation are based on medical coding. An accurate representation of the patient’s health journey, appropriate reimbursements, and avoiding potential legal pitfalls are crucial to ensuring accurate representation of the patient’s health journey, not just an administrative formality. […]
Learn More
7-Tips-for-Diagnostic-Radiology-Coding

7 Tips for Diagnostic Radiology Coding

Adhere to the guidelines provided by CPT®, ACR, and payers to ensure precise reporting and appropriate reimbursement. Diagnostic radiology encompasses a diverse array of services, including diagnostic radiology (plain film), diagnostic ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), diagnostic nuclear medicine, positron emission tomography (PET), and mammography. The following seven pointers are relevant to […]
Learn More
Fracture Care Coding

Get a Global Perspective on Orthopedic Fracture Care Coding

Assist physicians and patients in gaining a precise comprehension of the situation. At orthopedic practices, coders frequently encounter a common question from patients: “Why does my invoice for an office visit include a surgical code?” This query is entirely reasonable, given that a patient was examined in the clinic, treated for a fracture, and later […]
Learn More
master-2022-cpt-changes-with-this-expert-overview

Master CPT® 2022 Coding With This Expert Overview

The CPT® 2022 edition incorporates a total of 249 novel codes, along with 93 codes that have been revised, and 63 codes that have been removed. Every segment of the CPT® code set has undergone modifications to codes and guidelines. The most substantial revisions are observed in evaluation and management (E/M) codes, spine-related procedures such […]
Learn More

Coding Tips to Help Your Practice Integrate Behavioral Health

The need to improve patient access to mental and behavioral health services is undeniable, and tools from the AMA and others are available to help primary care practices integrate these services into their workflow and ensure they are properly paid for these services. When North-western Medicine needed to provide greater access to behavioral health services […]
Learn More

New Coding Rules for 2021

New 2021 Coding Rules Q: Do the new 2021 coding rules for office visits apply to all payers or just Medicare and Medicaid? Also, are these rules just for office visits, or can we use them for hospital visits, nursing home services, and home visits? A: The changes to the documentation requirements are for codes […]
Learn More

2021 AMA E&M Changes: A Provocative Overview

Many of us have been immersed in COVID-19 and telehealth billing, coding, and the varying rules among payors of late, all the while the clock has remained ticking on the looming changes to evaluation and management (E&M) services, effective Jan. 1, 2021. It is possible, too, that there are those who have not heard of […]
Learn More

CMS Guidance for Remote Patient Monitoring (RPM)

The Centers for Medicare & Medicaid Services (CMS) has provided some guidance within the “Medicare and Medicaid Programs Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency” interim final rule (IFR), allowing for remote patient monitoring, or RPM. This type of patient care is very helpful for ongoing treatment during the COVID-19 […]
Learn More
x