On Sept. 8, the American Medical Association (AMA) released two new codes related to the coding and reporting of COVID-19 testing and management. The additions include one new code in the Pathology and Laboratory sections and one new code in the Medicine section of CPT. A summary of the new…
Choosing a proper office visit code can become confusing unless one understands the rules separating preventative medicine and evaluation and management coding. Preventative medicine codes are meant only for the reporting of asymptomatic patients. In order to assign a preventative code, a comprehensive evaluation must be documented. The scope of…
Reimbursement has not been established at this time. The American Medical Association (AMA) CPT® Editorial Panel has revised one code and created two new codes to provide more specificity for serology laboratory testing.   The codes, which were published on April 10, are effective immediately. Reimbursement has not been established for…
A year before CPT® rules change, payers are expected to crack down on E&M codes. Even as a major change to outpatient evaluation and management (E&M) codes looms next year, a development that would reduce the documentation burden on providers, commercial insurance companies are cracking down this year on E&M…
More changes are likely coming. As many of you have heard, there are major changes coming to evaluation and management (E&M) codes in 2021. The changes were finalized in the 2020 Physician Final Rule.  The good news is that the Centers for Medicare & Medicaid Services (CMS) gave us all…
Medical coding errors fall into the broad categories of “fraud” and “abuse.”  Medical practices are concentrating on critical practice changes in 2020 and 2021, but it is important not to lose focus on the basics of correct coding. Don't be guilty of common CPT and ICD-10-CM coding errors, as it…
Success can cost you more than you thought it would. You might have heard the phrase, “everyone wants to be successful until they see what it actually takes.”  While I’m not sure where the quote originates, I’ve seen it attached to various images, one of which is the feet of…
There are lessons to be learned to avoid damaging coding habits. Wound debridement is a medical procedure that removes infected, damaged, or dead tissue to promote healing. Debridement is generally associated with injuries, infections, wounds, and/or ulcers. It is also a procedure that may be part of fracture care as…
The risks of using the Internet to self-diagnose and code. A majority of us turn to the Internet for health-related information. According to the Pew Research Center, in 2014, a total of 87 percent of American adults had access to the Internet, and in 2012, a total of 72 percent…
Three revenue cycle tips are provided to reduce denied claims. Claim denials represent millions of dollars in lost and delayed net reimbursement annually. According to the American Medical Association (AMA), cost estimates of inefficient healthcare claims processing, payment, and reconciliation top out at $210 billion per year. Denials are so…