Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
It is expected that the Centers for Medicare & Medicaid Services (CMS) will release a completely revamped version of the evaluation and management (E&M) codes by 2021, particularly for the office visit codes (999201-99205 and 99211-99215). In addition to the changes to the office visit codes, there were significant changes to the 2023 guidelines. These […]
In the world of healthcare, medical coding plays a crucial role in ensuring accurate billing and reimbursement for services provided to patients. As we look ahead to 2023, there are several trends that are expected to shape the landscape of medical coding. Here are five of the most significant trends to watch for: 1. Increased […]
Newly introduced as of July 1, 2023, are updated CPT® codes detailed in MLN Matters 13210, issued on June 13. Accompanying this, a supplementary document, Change Request 13210, offers more comprehensive insights. Included in the fresh set of codes are those related to COVID vaccination and its administration. Specifically, 0174A pertains to administering the Pfizer-BioNTech […]
In the ever-evolving field of healthcare, accurate diagnosis and effective treatment depend on a universal coding system that provides a common language for medical professionals worldwide. The International Classification of Diseases (ICD) serves as the backbone of this system, and with the recent transition to ICD-11, a new era of coding has begun. In this […]
Severe maternal morbidity often intersects with cesarean deliveries. Reducing the number of cesarean deliveries can lower the maternal mortality rate, and one of the drivers of cesarean rates is thought to be induction of labor (IOL). In 2014, the American College of Obstetricians and Gynecologists (ACOG) adopted definitions for labor, labor induction, and augmentation of […]
What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II codes for COVID-19 therapeutic injections; and Medicare payment allowances for the 2021-22 influenza vaccine codes have been released. FDA Approves COVID-19 Vaccine Pfizer’s COVID-19 vaccine received the […]
Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
There are a slew of changes and only a few months before you will need to start using the new codes. The Centers for Medicare & Medicaid Services (CMS) released on July 1 the ICD-10-CM code descriptions, tables and index, and addendum for fiscal year 2021. There are 490 additions, 58 deletions, and 47 revisions — increasing […]
The Centers for Medicare & Medicaid Services (CMS) has removed two Healthcare Common Procedure Coding System (HCPCS Codes) codes just days before the bid window opens. Codes E0992 and K0056 have been dropped from the standard power mobility devices product category as they are only applicable to the standard manual wheelchairs product category. Due to […]










