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Diabetes screening

Medicare Announces NEW Coverage for Diabetes Screening

It isn’t often that CMS expands its screening coverage to pay for more tests, but that time arrived earlier this month, when the agency announced upgraded Medicare pay for an additional diabetes screening test. The agency also slightly changed the diabetes screening guidelines to make them more favorable and easier to follow. Find out what […]
CPT 2025

Sneak Peek: CPT 2025 to Include Plethora of New Codes

Eye screenings, hearing device services, lab codes and more are expected to join the new edition of CPT when it debuts later this year. Although the American Medical Association hasn’t officially released the new codes, it is possible to get clues of what you can expect by reviewing the CPT 2025 Editorial Panel’s latest decisions. […]
New icd-10-cm codes

CMS Proposes Over 200 New ICD-10-CM Codes for 2025

If you’re hungry for a new crop of diagnosis codes, you may be in luck this October, assuming the newly-proposed diagnosis codes become actual, finalized new ICD-10-CM codes. Background: On April 10, CMS released the FY2025 Hospital Inpatient Prospective Payment System proposed rule for 2025, and tucked within the rule was a file sharing the […]
Critical care codes

3 Important Facts About Billing Critical Care Codes 99291-99292

Reporting the critical care codes (99291-99292) can lead to mass confusion for many coders and billers. After all, these services are considered both inpatient care and E/​M services — but they follow slightly different rules than most other inpatient E/​M codes. To get a handle on how to report the critical care codes at your […]
2024 ICD-10-CM

Ace the April 2024 ICD-10-CM Changes Before Next Week

Every medical coder and biller knows that the best way to justify medical necessity in your claims system is to use the right diagnosis codes. And while the 2024 ICD-10-CM codes were released last fall, CMS recently issued an April update that could turn your coding processes upside-down. Check out several April 2024 ICD-10-CM changes […]
Same-day admit/discharge

Let These Examples Guide Your Same-Day Admit/Discharges

When CPT eliminated observation care designations from its coding lineup in 2023, some coders were puzzled about how to report same day admit and discharge situations, and the rules have only become more confusing as the calendar turned to 2024. After all, there are always going to be situations when patients are admitted to observation […]

New G2211 Facts Help Guide Your E/M Reimbursement Strategy

Sometimes it may feel like you’re navigating the G2211 coding and payment rules without much guidance, since CMS updates about how to report this E/​M add-on have been sparse. Fortunately, one Part B MAC has come out with nearly a dozen FAQs that untangle several issues that coders have encountered since this code became payable […]
Two e/m visits

Two E/M Visits Same Day? Check 3 Tips to Collect for Both

With every near year comes new coding guidelines, and CPT definitely delivered a lot of E/​M changes over the past few years. Most recently, the AMA provided new clarifications on how to report two E/​M visits on the same date of service. If you see a patient twice in the same day — whether it’s […]
Transgender patient

4 Tips Help You Collect for Transgender Patient Services

Nearly 2 million Americans identify as transgender, meaning their gender identity is different from what they were assigned at birth. If your practice sees a transgender patient — even if the visit isn’t related to gender transition services — you may need to know which diagnosis codes apply to the visit, and that’s not always […]
Inpatient coding

3 FAQs About Inpatient E/M Coding — With Official Answers

Coding for evaluation and management (E/​M) services has gotten a lot more complicated over the past few years. From descriptor changes to code deletions, you may take longer than usual to code a hospital encounter. Your best bet in these situations is to consult the inpatient coding guidance straight from payers. Check out three common […]