Start Your FREE Membership NOW
• Discover Proven Ways to Be a Better Medical Office Manager
• Get Our Daily eNewsletter, MOMAlert, and MUCH MORE
• Absolutely NO Risk or Obligation on Your Part -- It's FREE!
EMAIL ADDRESS

Upgrade to Premium Membership NOW for Just $90!
• Get 3 Months of Full Premium Membership Access
• Includes Our Monthly Newsletter, Office Toolbox, Policy Center, and Archives
• Plus, You Get FREE Webinars, and MUCH MORE!
Home » topics » Coding Alert
CODING & BILLING

CPT update for COVID-19 boosters adapted to omicron

5:01 pm by

The American Medical Association has announced an update to Current Procedural Terminology (CPT)®, that includes eight new codes for the bivalent COVID-19 vaccine booster doses from Moderna and Pfizer-BioNTech. The updated boosters are adapted for the BA.4 and BA.5 Omicron subvariants and the original coronavirus strain in a single dose. Four of the eight CPT codes (91312, 91313, 0124A and 0134A) are effective for use immediately as the U.S. Food and Drug Administration (FDA) has authorized Moderna’s new COVID-19 booster in individuals 18 years of age and older and Pfizer-BioNTech’s new COVID-19 booster in individuals 12 years of age and older. Four CPT codes (91314, 91315, 0144A and 0154A) will be effective for use on the condition that the FDA authorizes Moderna’s new COVID-19 booster in individuals 6 years through… . . . read more.

TAGGED WITH: , , ,
KICKBACKS

OIG issues fraud alert on pharmaceutical company in-person speaker programs

9:17 pm by

Before the pandemic put the chill on live conference events, it was fairly common for pharmaceutical companies, device makers and diagnostics companies to offer healthcare professionals fees for in-person speaking appearances. Such practices raise red flags under the federal Anti-Kickback Statute (AKS) when those speakers recommend the products of those companies to their patients. So, on Nov. 16, the OIG issued a Special Fraud Alert warning companies about restarting in-person paid healthcare professional speaker programs when COVID-19 restrictions lift. OIG Skepticism of Speaker Fees Program Federal government suspicion of paid speaker programs, especially by pharmaceutical companies, is nothing new. For example, Novartis recently agreed to pay $678 million to settle a seven-year-long legal battle with the OIG over allegations of using its speaker programs as a way to disguise bribes to… . . . read more.

TAGGED WITH: , ,
CODING ALERT

Physicians should consider these overlooked codes

9:08 am by

By Lisa Eramo bio It’s a common complaint heard among primary care physicians: Evaluation and management (E/M) codes don’t adequately capture the time, skill, and resources necessary to plan and coordinate care for patients with complex medical needs. Although new, streamlined E/M guidelines for 2021 may help, several existing remedies can enable physicians to capture additional revenue for the services they provide. More specifically, the U.S. Government Accountability Office (GAO) has published a list of 58 CPT codes that fall under the category of “longitudinal comprehensive care planning” (LCCP) for Medicare beneficiaries diagnosed with a serious or life-threatening illness. These codes include elements of shared decision-making through interdisciplinary care as well as development of a care plan to address the following: Progression of the disease and treatment options Beneficiary’s goals,… . . . read more.

TAGGED WITH: , ,
CODING ALERT

Reasons for health services encounter get codes in Chapter 21 of ICD-10

8:02 am by

By Judy Monestime  bio
Codes included in Chapter 21, Factors influencing health status and contact with health services (Z00-Z99), represent reasons for encounter. Z codes are provided for encounters when circumstances other than diseases or injury are recorded in the medical record as the diagnosis.
The chapter includes the following sections…

 

. . . read more

TAGGED WITH: , ,
CODING ALERT

Frequently coded conditions in Chapter 4 of ICD-10 CM

8:03 am by

By Judy Monestime  bio
Chapter 4 in ICD-10 CM contains codes for endocrine, nutritional and metabolic diseases (E00-E89). The chapter includes frequently coded conditions such as disorders of the thyroid gland, obesity, dehydration, and diabetes mellitus…


. . . read more

TAGGED WITH: , ,
CODING ALERT

Multiple coding now required for nervous system diseases

8:01 am by

By Judy Monestime  bio
ICD-10 CM’s Chapter 6 Diseases of the Nervous System (G00-G99) includes diseases of the central and peripheral nervous systems as well as epilepsy, migraine, and other headache syndromes. Many codes include a combination of conditions, such as persistent migraine aura with cerebral infarction, intractable (G43.61-).
The following conditions have been moved from ICD-9-CM Chapter 7: Diseases of the Circulatory System, to ICD-10-CM Chapter 6: basilar and carotid artery syndromes, transient global amnesia, and…

. . . read more

TAGGED WITH: , , ,
CODING ALERT

Coding tips for respiratory diseases

8:01 am by

By Judy Monestime  bio
ICD-10-CM Chapter 10, “Diseases of the Respiratory System (J00–J99),” identifies codes for a wide variety of pulmonary conditions, ranging from acute upper respiratory infections, pneumonia, influenza, asthma, as well as diseases of the lower respiratory tract including chronic lung diseases and diseases acquired from exposure to external substances. Intraoperative and postprocedural complications are also available to be coded in this chapter.
The chapter includes the following…

. . . read more

TAGGED WITH: , , , , ,
CODING ALERT

ICD-10 is more detailed for osteoporosis and musculoskeletal conditions than ICD-9

8:01 am by

ICD-10 M81 Osteoporosis without current pathological fracture
By Judy Monestime  bio
Chapter 13 Diseases of the musculoskeletal system and connective tissue (M00-M99); M stands for Musculoskeletal, contains many more subchapters, categories, and codes than ICD-9-CM. Rather than having just four subchapters grouping many conditions together, ICD-10-CM organizes the musculoskeletal system and connective tissue in the following blocks:…

. . . read more

TAGGED WITH: , , ,
CODING ALERT

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

8:02 am by

By Judy Monestime  bio
Chapter 21 in ICD-10-CM contains codes for factors influencing health status and contact with health services. There are differences in ICD-10-CM from what is currently found in ICD-9-CM.
Some categories in Chapter 21 have rephrased titles to better reflect the situations the codes classify. For example, elective, legal, or therapeutic abortions have been moved from ICD-9-CM Chapter 11, Complications of Pregnancy, Childbirth, and the Puerperium, to ICD-10-CM Chapter 21. Also, several codes have been expanded in ICD-10-CM; for example…

. . . read more

TAGGED WITH: , , ,
CODING ALERT

Chapter on diseases of the skin and subcutaneous tissue is a total revamp

8:03 am by

By Judy Monestime  bio
ICD-10-CM Chapter 12, “Diseases of the Skin and Subcutaneous Tissue (L00-L99),” represents a complete restructuring to bring together groups of diseases that are related to one another in some way. For example, dermatitis and eczema are separated from urticaria and erythematous conditions. Additionally, greater specificity has been added to many of the codes at either the fourth, fifth or sixth character level. Most of these diagnoses codes will require additional documentation and queries for specificity. For example, laterality, site, and stage of…

. . . read more

TAGGED WITH: , , ,

(-0)