Coding Tips Obesity and morbid obesity are always clinically significant and reportable when documented by the provider. (Coding Clinic 4th Quarter 2018 p.77). 1) being 100 lbs or more above ideal body weight; or 2) having a BMI of 40 or greater; 3) having a BMI of 35 or greater with one or more obesity… Read More »Adult Obesity/Morbid Obesity with BMI >35
CKD as defined by NKF KDOQI: kidney damage for >3 months • For CKD to be diagnosed, one of the following criteria must be present for >3 months: • CKD stage is determined by the stable GFR: Stage GFR ESRD Dialysis-dependent stage 5 Provider documentation should be clear if… Read More »Chronic Kidney Disease
The accurate classification and documentation of diseases are key, especially in the case of neoplasms. The importance of precise diagnosis coding cannot be overstated. With advancements in medical knowledge and technology, understanding the intricacies is crucial for healthcare professionals striving to provide optimal care for their patients.
As we step into 2024, the landscape of healthcare continues to evolve, with Medicare introducing significant updates in evaluation and management (E/M) coding. Among the most notable changes is the introduction of new care management codes, promising to streamline and enhance the delivery of patient care for Medicare beneficiaries.
2024 brings significant CPT code revisions. This guide will identify important guidelines & parenthetical note additions & revisions. We’ll review anatomy & other pertinent clinical information important to understanding the new CPT codes. Important note – due to significant code changes & guideline revisions, a module published in January will provide a more thorough &… Read More »2024 CPT Update Guide
CMS updates the NCCI Policy Manual for Medicare Services once a year. This is a general reference tool that the Medicare Administrative Contractors (MACs) use to explain the rationale for NCCI edits. The most current policy manual is effective January 1, 2024. Note additions and revisions are noted in red font. CPT and HCPCS code… Read More »2024 NCCI Policy Manual for Medicare Services
2024 CPT TRFA Updates We continue our deep dive into the 2024 CPT changes this week with updates to the codes for Transcervical Radiofrequency Ablation of Uterine Fibroids (TRFA). Category III code 0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, RF has been deleted and a new Category I code 58580 has been created for… Read More »2024 CPT Blog: Part 3
Social determinants of health (SDOH) are the non-medical factors that influence health outcomes. Providers can receive additional reimbursement when they document and address those SDOH that impact a patient’s treatment. CMS finalized coverage of HCPCS code G0136 (administration of a standardized, evidence-based SDOH risk assessment tool, 5-15 minutes) beginning January 1, 2024, In order to report G0136… Read More »Social Determinants of Health
2024 CPT VBT Updates We continue our deep dive into the 2024 CPT changes this week with a focus on the new established Category I codes and impacted Category III codes for Anterior Thoracic Vertebral Body Tethering (VBT) due to increased adoption and utilization. VBT is used to correct scoliosis without spinal fusion using a… Read More »2024 CPT Blog: Part 2
2024 E/M Time Revisions The goal of this blog series is to investigate further the changes to CPT in 2024. We’ll begin with E/M time revisions. The Evaluation & Management section saw major changes for office visits in 2021 including assigned “time ranges for E/M codes 99202 – 99205 and 99212 – 99215. In 2023… Read More »2024 CPT Blog: Part 1