AMA updated the CPT code set to accommodate the new mix-and-match COVID-19 vaccine booster strategy endorsed by the federal government. The update comes on the heels of a decision from the Federal Drug Administration (FDA) to authorize booster doses of Janssen’s COVID-19 vaccine. The federal agency has recommended a booster dose of the vaccine for […]
Coding blood transfusions on maternity patients saves lives. If you are a “frontline” coder buried in the minutiae of day-to-day coding, discussions about quality initiatives may not be in the forefront of your brain. We often hear of the importance of these programs in improving patient outcomes, and how critical “accurate and consistent” coding is. […]
While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact, the U.S. has twice as many maternal deaths than other high-income countries. To reverse this trend, The Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and the Agency for Healthcare Research […]
To prepare for potential FDA authorization, AMA has released new CPT codes for pediatric doses of the Pfizer COVID-19 vaccine. In September 2021, Pfizer and BioNTech shared the results of a Phase 2/3 clinical trial in which two doses of the vaccine elicited a strong immune response in children ages 5 to 11. Following the […]
Here is an important checklist to help you prepare for new codes effective now. On Oct. 1, the new 2022 fiscal year (FY) ICD-10-CM/PCS codes became effective. The new CM code set includes 159 new codes, 20 revised codes, and 18 deleted codes. The new ICD-10-PCS code set include 191 new codes, 62 revised titles, […]
In the latest Medicare Physician Fee Schedule, the U.S. Centers for Medicare and Medicaid Services proposed for the first time a set of CPT codes for remote therapeutic monitoring. These codes, according to the proposal, are intended to be used to understand the effectiveness of and the patient’s response to a prescribed therapy. In particular, […]
Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
The American Medical Association’s (AMA’s) CPT® Editorial Panel has released eight new COVID-19-related codes to report a new formulation of the Pfizer vaccine, a Moderna booster vaccine, and a Pfizer booster using either the new or old formulation. These codes are in addition to the four new CPT codes released last month and the many […]
Midland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not have a primary COVID-19 diagnosis. The Texas hospital told local news source News West9 that it miscoded 87 claims last November and sent those claims […]
The updates include unique CPT codes for a new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses expected to roll out later this month. The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster […]