Contest indicates coding accuracy is below expectations. Central Learning is a web-based coding assessment and education application. Since 2016, the company has conducted an annual national coding contest to measure ICD-10 coding accuracy and production. The initial premise was to evaluate how coding accuracy and production work, compared to ICD-9.…
“Virtual" peer reviews are a covered benefit for most payers. In keeping with our theme of “communication-based services,” let’s take a closer look at the inter-professional consults and referrals that do not include a face-to-face encounter with a patient. Some are existing CPT® codes, and two new codes, in this…
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…
New strategy holds promise for future extensions of this technology.A medical practice can now bill and collect for a specific telehealth service without the strict rules of the originating sites being outside of a Metropolitan Statistical Area (MSA) or in a rural Health Professional Shortage Area (HSPA) located in a…
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…
Confusion persists in understanding the definition of the two visits. We created a lot of buzz the past two weeks on our Talk Ten Tuesday broadcast an article on new versus established patient visits: so much, in fact, it was hard to keep up with all the email feedback, which…
“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during…
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…
Coders must ensure documentation supports the service, either moderate sedation or MAC. Coding moderate sedation (or conscious sedation) and monitored anesthesia care (MAC) is not difficult; however, distinguishing what the services provided are and deciphering conflicted information about which physicians can report what codes can be confusing for some coders…
Address documentation and coding issues up front, rather than correct them later. Coders have had many challenges throughout the years.  When I started in the industry, we did not submit claims electronically; they were submitted on paper and we used an IBM Selectric Typewriter to complete what was then the…
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