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Coding Tips

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2024 Evaluation & Management Updates

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.

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coding Tip - CPT Updates

2024 CPT Update Guide

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 &…

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2024 NCCI Policy Manual for Medicare Services

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…

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2024 CPT Blog: Part 3

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…

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Coding Tip SDOH

Social Determinants of Health

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…

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2024 CPT Blog: Part 2

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…

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2024 CPT Blog: Part 1

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…

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HCC Blog – Part 4

Continued discussion surrounding the RA/HCC V28 changes. This week we’re going to re-visit a few of the RAF/HCC perceptions to alleviate possible confusion.  Recently, I had a few conversations about RAF/HCCs that leads me to believe there is some misunderstanding about the overall concept of this prospective payment system.  There are two models for HCC…

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CPT 2024 Changes – Here we come!

Here is our cheat sheet for changes you can expect to CPT in 2024. Overview: Here is a quick summary of some of the more significant changes. Evaluation & Management Surgery: Musculoskeletal Surgery: Respiratory System Surgery: Cardiovascular System Surgery: Urinary System Surgery: Female Genital System Surgery: Nervous System Surgery: Eye & Ocular Adnexa Radiology Pathology…

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Sample Neoplasm Disease Group 5 HCC Changes

Bi-Weekly RA/HCC V28 Changes Discussion

In this week’s RA/HCC discussion, we are looking at a few of the HCC modification changes.  As previously discussed, the HCC changes are extensive and the information provided below are just a few examples of these V28 changes. Neoplasm Disease Group Liver Disease Group Blood Disease Group Cognitive Disease Group Substance Use Disorder Disease Group…

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2024 ICD-10-DRG Updates

To round up our other ICD-10 update guides, the team has pulled together a guide for the DRG updates for 2024. In this guide you’ll find:

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ICD-11 Monthly – October 2023

Comparing Codes Across ICD Versions: Heart Failure In this month’s ICD-11 deep dive, UASI’s Mary Stanfill continues to examine the differences between ICD-10 and ICD-11 to get a feel for how these changes will impact day-to-day coding. The WHO ICD-11 classification is very different from the 10th version that the United States modified to create…

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