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Advance care planning

Avoid These Advance Care Planning Errors to Keep Pay Flowing

Is your practice reporting advance care planning (ACP) properly? If you’re like the majority of practices that the OIG recently audited, you’re probably documenting these incorrectly, which could mean you’ll need to pay money back to Medicare. Here’s why: A recent OIG audit revealed that out of 691 ACP services they reviewed, 466 didn’t comply […]
CPT code 99211

Check These Four Documentation Rules for Reporting 99211

Your nurses are vital to your office’s operations, and the income they generate is vital as well. But if you don’t ensure that they document their visits properly, you could be throwing thousands of dollars out the window. That’s because payers and government auditors are reviewing documentation for nurse-visit CPT code 99211, and if they […]
risk adjustment

Risk Adjustment: Are You Self-Auditing ICD-10-CM Codes?

Medical practices can get paid more for Medical Advantage claims by accurately reporting patient risk—but the main way insurers evaluate risk is through your diagnosis codes. And if your practice isn’t performing ICD-10-CM self-audits, you could be underrepresenting your risk and shorting your practice significant income without even knowing it. Background: Risk adjustment is a […]
ICD-10 Z codes

Clearly Describe Patients’ Conditions With NEW ICD-10 Z Codes

If your practice is like most, you’ve been busily working to add the 2023 ICD-10-CM codes to your electronic health records and superbills to prepare for the Oct. 1, 2022 implementation date. But one area that many practices may not have spent much time absorbing involves the ICD-10 Z codes that are new this year. […]
2023 CPT

CPT 2023: New E/M Code 99418 Among Big Jan. 1 Changes

The end of the year is approaching, and for coders, that always means getting to know a whole new set of procedure codes that take effect January 1. The 2023 CPT code set debuted last week, and includes 393 changes, with most of them (225) consisting of new codes. You’ll also find 75 deletions and […]
ICD-10-CM guidelines

Aced the New ICD-10 Codes? Now Master Guideline Changes

You’ve got less than a month before you must start using the 2023 ICD-10-CM codes, but just as importantly, Oct. 1 is also the deadline for you to start following the 2023 ICD-10-CM Guidelines, and you’ll find major updates to those rules hitting next month. Here’s what they are: The ICD-10-CM Guidelines provide instructions for […]
Telehealth Claim Denial

Claim Denial Telehealth: Check 2 Items Before Refiling

QUESTION: We just received our first denial for a telehealth service using audio-visual. The claim was filed with office visit code 99212, place of service 02 for telehealth and modifier 95. Can you tell us what we did wrong so that we can get paid for these visits? Question from Palatine, Illinois Subscriber ANSWER: Based […]
RTM codes

Boost Payup, Improve Patient Care with 2022 RTM Codes

You can now get paid more for using digital health technology with your patients. As of January 1st, new codes for Remote Therapeutic Monitoring (RTM) allow you to get reimbursed for monitoring non-physiologic data. These codes opened up more patient care options, allowing your practice to use newer technology and still get reimbursed for it. […]
Unvaccinated patients

New ICD-10-CM Codes for Partially & Unvaccinated Patients

You’ll soon have new ICD-10-CM Z codes to report when treating patients who are partially vaccinated or unvaccinated for COVID-19. Unvaccinated patients. This new code set, effective April 1, 2022, includes four additions under Chapter 21 (Factors influencing health status and contact with health services). The codes were added to better track those who aren’t […]
Coding for COVID-19 Vaccines

Improve Accuracy & Boost Pay-up with New COVID Vaccine Codes

The American Medical Association (AMA) recently issued 11 new Current Procedural Terminology (CPT) codes to help make your coding for COVID-19 vaccines more accurate – and hopefully improve your reimbursement. So if your practice is administering vaccines under the Centers for Disease Control and Prevention’s (CDC) COVID-19 Vaccination Program — the only way to legally […]