Tag: medical-coding

Billing for Tetanus Vaccine? Check the Diagnosis

Billing for Tetanus Vaccine? Check the Diagnosis

Did you know that tetanus vaccines are covered under Medicare Part B only when administered for treatment purposes? Preventive tetanus vaccinations do not fall under coverage. The Centers for Medicare & Medicaid Services Internet-Only Manuals Pub. 100-02, Chapter 15, Section 50.4.4.2 clarifies, “Vaccinations or inoculations are excluded as immunizations unless they are directly related to […]
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Coding Drives Up Medical Billing Costs in US

Coding Drives Up Medical Billing Costs in US

Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
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Master CPT 2022 Coding With This Expert Overview

CPT 2022 Code Updates

The CPT 2022 code updates introduced significant revisions across nearly every section of the Current Procedural Terminology (CPT®) code set. These changes affect Evaluation and Management (E/M), surgery, pathology, laboratory, radiology, anesthesia, and COVID-19 vaccine administration. Staying current with these revisions is essential for accurate coding, compliant claim submission, and optimal reimbursement. Overview of CPT […]
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The Impact of Coding on Maternal Outcomes_ Part III

The Impact of Coding on Maternal Outcomes: Part III

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 […]
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2022 ICD-10-CM Guidelines Released

FY 2022 ICD-10-CM Official Guidelines

The FY 2022 ICD-10-CM Official Guidelines for Coding and Reporting introduced several important changes that medical coders, healthcare providers, and revenue cycle teams needed to understand before the October 1, 2021 implementation date. The updated guidelines provided clarification on documentation, laterality, COVID-19, diabetes, pressure ulcers, coma coding, social determinants of health, and several other areas. […]
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FY 2022 ICD-10-CM Codes Now Available

FY 2022 ICD-10-CM Codes

The FY 2022 ICD-10-CM code set introduced important changes for healthcare providers, medical coders, and billing professionals. Released by the Centers for Disease Control and Prevention (CDC), the new code set included 159 new ICD-10-CM codes, along with updates to the Tabular List, Alphabetic Index, and related addenda. The new codes became effective October 1, […]
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Prolonged Services in CPT versus Medicare

CPT 99417 vs. G2212

The 2021 changes to Evaluation and Management (E/M) coding significantly changed how physicians and qualified healthcare professionals could select office and other outpatient visit codes based on time. Instead of relying on “typical” times, the revised CPT® guidelines introduced specific time ranges for each level of service. These changes also created an important distinction between […]
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ICD-10-CM Coding For Autoimmune Hemolytic Anemia

Cold antibody hemolytic anemia is a rare autoimmune disorder characterized by the premature destruction of red blood cells by autoantibodies at temperatures of approximately 0 to 10 degrees Celsius. Q: What is the difference between cold, hot, and mixed type autoimmune hemolytic anemia, as described by 2021 ICD-10-CM codes D59.11-D59.13? A: ICD-10-CM code category D59.- (acquired […]
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Sequence ICD-10-CM Codes for Proper Payment

Key Concepts for Determining Primary Diagnosis Codes

Accurate diagnosis coding is crucial for medical billing, as it narrates the patient’s healthcare journey. Patients often present with multiple conditions, requiring coders to select and sequence the most specific codes. This sequencing, or code arrangement, is vital for correct billing. This discussion highlights five key terms from the ICD-10-CM Official Guidelines for Coding and […]
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