Tag: Medical coding company

Payers Wrongly Cutting Payments To Physicians For E/M Services

Payers Wrongly Cutting Payments To Physicians For E/M Services

Payers have been wrongly cutting payments to physicians for evaluation-and-management (E/M) services—often automatically through the use of claim-editing algorithms. A new AMA resource helps physicians fight back against health insurer downcoding. Downcoding happens when a payer changes a claim to a lower-cost service than what was submitted by the physician, leading the practice to get […]
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ICD-10-CM Codes for Diabetes Mellitus Symptoms

ICD-10-CM Codes for Diabetes Mellitus Symptoms

In 1991, International Diabetes Federation (IDF) & World Health Organization (WHO) combine to create World Diabetes Day (WDD) on November 14 and we take this day to spread awareness and education on Diabetes, a chronic disease where pancreas won’t produce enough insulin which leads to serious health issues. Many physician and health providers will struggle […]
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CPT® and HCPCS Newly Added and Revised Codes

CPT® and HCPCS Newly Added and Revised Codes

CPT® codes are effective Jan. 1, 2023. The American Medical Association (AMA) released CPT 2023 on Sept. 12. There are 225 new codes, 75 deletions, and 93 revisions. Most of the changes fall in the Evaluation and Management (E&M) section. The 2023 CPT codes are effective Jan. 1, 2023. The October 2022 release of the […]
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CPT Code Set Released for the year 2023

CPT Code Set Released for the year 2023

The American Medical Association (AMA) says the 2023 CPT code updates emphasize its efforts to reduce administrative tasks. The AMA released the calendar year 2023 CPT code set, which builds on the AMA’s efforts to reduce administrative tasks in medicine, according to a recent press release. The CPT code update contains 393 changes, including 225 […]
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Important 2023 E&M Code Changes for Prolonged Services

Important 2023 E&M Code Changes for Prolonged Services

Among the changes are a new code for reporting prolonged services in the inpatient or observation setting and significant guideline revisions. The American Medical Association (AMA) recently announced major revisions to Evaluation and Management (E&M) Services, effective Jan. 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, […]
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CMS Includes HCPCS Level II Code Changes

CMS Includes HCPCS Level II Code Changes

Dozens of additions, deletions, and revisions are effective Oct. 1, 2022. The October 2022 update to the HCPCS Level II code file from the Centers for Medicare & Medicaid Services (CMS) includes more than 40 changes, and most of them are new codes. The changes are effective Oct. 1, 2022, with a few important exceptions. […]
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Intricacies of the 2021 E/M Coding Guidelines

Intricacies of the 2021 E/M Coding Guidelines

Industry experts explain the intricacies of the 2021 E/M coding guidelines. During the Evaluation and Management (E/M) Panel general session, an expert panel made up of a physician, coder, auditor, payer, and a representative from the American Medical Association (AMA) answered audience questions regarding the 2021 E/M coding guidelines for office/outpatient visits. The panelists were […]
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Outpatient and Inpatient Consultation Services can be Tricky

Outpatient and Inpatient Consultation Services can be Tricky

The AMA updated consultation services for 2023. The American Medical Association (AMA) announced major revisions to Evaluation and Management (E&M) Services for Jan 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, emergency department services, consultations, nursing facility services, home and residence services, and prolonged services. Revisions […]
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