Posts by Marcy Blitch

Currently there is no specific device value for the COVID-19 booster and or third COVID-19 vaccination. Assign the sixth character device value “U,” COVID-19 vaccine, when the additional dose is provided to the patient. A proposal for a new ICD-10-PCS code was presented by the Centers for Medicare and Medicaid at the September 2021 ICD-10…

Learn more about codes 33995 and 33997, which are new to the 2021 Current Procedural Terminology (CPT).

The Glasgow Coma Scale (GCS) is a clinical scale used to measure a person’s level of consciousness after a brain injury. The scoring is determined by three factors: amount of eye opening, verbal responsiveness, and motor responsiveness. The Glasgow Coma Scale has an adult version and a pediatric version. The pediatric version is also composed…

Critical limb ischemia, also known as chronic limb-threatening ischemia, is a clinical syndrome of peripheral artery disease of the lower limbs with ischemic pain at rest and ischemic tissue such as nonhealing ulcers or gangrene. Critical limb ischemia (CLI) does not happen overnight and does occur over time. Patients are at a much higher risk…

Effective August 11, 2020, the Centers for Medicare & Medicaid Services resumed the Comprehensive Error Rate Testing program activities that were temporarily suspended in response to the public health emergency for the 2019-Novel Coronavirus (COVID-19) pandemic. CMS uses Comprehensive Error Rate Testing to verify Medicare Administrator Contractors are properly paying claims. CERT audits coding and…

Medical claims denials in 2019 approached $9 billion. The denial rate in 2020 increased by 23%. Coding/billing errors accounted for approximately 15% of all denials. Specificity of coding was one of the reasons claims were denied. In 2019, stroke was the leading cause of death and killed approximately 140,000 Americans. Three Simple Questions to Ask…

The inpatient only list is composed of procedures for which Medicare will only pay for when performed in the hospital inpatient setting. CMS has determined this list to be an area of concern in that it restricts patient choice when it comes to surgery. CMS has proposed to eliminate the list over the next three…

COVID-19 is a complex disease with a wide spectrum of clinical patterns. COVID-19 was initially viewed as primarily a respiratory disease, but is now recognized as a complex disorder affecting many body systems. Coding professionals need to be knowledgeable of the testing of COVID-19 (e.g., diagnostic and antibody tests) and the COVID-19 disease processes (e.g.,…