AMA is on track to revise E&M codes, set new documentation guidelines. The American Medical Association’s (AMA’s) CPT® Editorial Panel has approved many changes to the evaluation and management (E&M) documentation and coding guidelines. If finalized, the changes will shift the way practices select codes for both office and facility visits as…
E&M code changes are expected to become effective in 2021. The American Medical Association (AMA) released on March 8 the summary of panel actions that took place at the February 2019 CPT® panel meeting. The exact wording is not considered to be finalized until just prior to the release of…
Not knowing the difference could amount to shortchanging yourself.It seems like the simpler the question, the harder it can be to answer. When we ask the question, “is this a new or established patient?” it amazes me that it is not a black-and-white answer. But when we look at the…
Skin biopsy codes are changing. EDITOR’S NOTE: This is an updated version of the second installment in a two-part series on the 2019 CPT® codes released recently by the American Medical Association.For many years we have used two codes to report skin biopsies. CPT® 11100 for the first lesion and…
New code changes number 335. The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019.  There were many code revisions with guideline, description and instructional note changes.   Let’s look at the highlights of many new CPT codes for 2019. There six new codes in the…
HATA survey reveals membership dissatisfaction with prior authorization transactions. In a recent report to the U.S. Senate Committee on Finance, the Government Accountability Office (GAO) was asked to examine the Centers for Medicare & Medicaid Services’ (CMS’s) prior authorization programs, including its benefits and challenges. The GAO spoke with many…
The author reports on the recently released American Hospital Association’s Coding Clinic. I was just able to free up the time to review the most recently published Coding Clinic (CC), and I will share my thoughts on the updates with you in this article. It took some energy to sort…
Achieving accurate and comprehensive coding of such issues is an imperative. Mental and behavioral disorders have recently had a media spotlight shone on them, and coding of these disorders can sometimes be tricky. Learning the nuances can help achieve accurate coding, which will enhance data necessary to make improvements in…
Medical policies are based off of evidence-based medicine. Without proper documentation, however, most providers struggle to get services or procedures covered for patients.Exactly what is medical necessity? To many, it is the belief that a service or procedure is warranted or justified for a patient. Others view it as a…
The American Medical Association (AMA) released new current procedural terminology (CPT®) codes during its 2018 CPT and RBRVS symposium held in Chicago Nov. 15-17.Significant changes to the 2018 CPT® codes and descriptors were announced late last week by the American Medical Association (AMA), including 170 new CPT codes, 60 revised…
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