medical coding training

Every year, the Centers for Medicare & Medicaid Services (CMS), and the American Medical Association (AMA) release updated coding and reporting guidelines that make additions, deletions, and revisions to the ICD-10 and HCPCS code sets, and CPT codes, respectively. During Public Health Emergencies (PHE), such as the COVID-19 pandemic, CMS and AMA will release updates more frequently. By offering ongoing medical coding training to cover these quarterly and annual updates, your coding team upholds an accuracy standard and stays compliant with these revised guidelines. YES Education offers a robust catalog of medical coding updates that refreshes as the code set revisions are released, including quarterly and annual updates for ICD-10-CM/PCS and CPT.

Read More
screening for COVID-19

This article offers guidelines on how to code screening tests for suspected COVID-19 infection. There are two different kinds of tests for COVID-19: a viral test to detect a current Coronavirus infection, and an antibody test to confirm is the patient previously had COVID-19 (CDC, 2020). The CDC has issued guidance on conducting screening tests for COVID-19 and other recommendations for viral testing (2020).

Read More
IPPS

The 2021 Proposed Rule for Inpatient Prospective Payment System (IPPS) was released on May 11, and will be published in the May 29, 2020, Federal Register (2020). Provisions in the rule increase the Medicare IPPS rate for hospitals that report quality data and are meaningful users of EHRs by approximately 3.1%, resulting in an increase of $2.07 billion in spending. With other adjustments, the overall payment increase for inpatient hospitals will be around 1.6%. The Proposed Rule adjusts the payment rates, MS-DRG codes, and other provisions, including new ICD-10-CM and ICD-10-PCS codes.

Read More
Telehealth and Covid-19

CMS clarified on April 10, 2020, that the submission of ICD-10-CM diagnoses codes for Risk Adjustment are permitted from coding telehealth services as long as it meets the set criteria (i.e. inpatient, outpatient, or professional service and from a face-to-face encounter) (CMS, 2020). CMS is stating that telehealth services can meet the face-to-face requirement “when the services are provided using an interactive audio and video telecommunications system that permits real-time interactive communication” (2020). From a medical coding and billing standpoint, the change in the telehealth services criteria for risk adjustment is causing updates to how these services are billed.

Read More

The COVID-19 Coding Guidelines webinar provides an overview and update on the new COVID-19 coding guidelines, including identifying the new Chapter 22 in ICD-10-CM such as the new code for COVID-19, describing the Official Coding and Reporting Guidelines applicable for COVID-19 infections, and assigning codes for given scenarios involving COVID-19 patient encounters. YES Educators Ann Zeisset, RHIT, CCS, CCS-P, and Teri Jorwic, MPH, RHIA, CCS, CCS-P, FAHIMA, lead this course.

Read More

On March 11, the World Health Organization (WHO) issued a declaration of the COVID-19 as a global pandemic. Two days later, the AMA announced the development of a specific code for laboratory testing for the coronavirus, code 87635 (AMA, 2020). The Centers for Medicare and Medicaid Services (CMS) released two new HCPCS codes for coronavirus testing for Medicare claims. The reporting for COVID-19 testing is dependent on the payer, either an HCPCS or CPT code should be used; there should not be more than one COVID-19 testing code on a given claim.

Read More
Coding

Medical coding is the process of assigning numeric or alphanumeric codes to the diseases, injuries, treatments, and procedures that healthcare providers perform to record each encounter accurately and correctly bill the patient (Healthcare Business & Technology, 2019). Medical coding directly ties into medical billing, which includes “preparing billing claims and submitting them to insurance providers,” as noted in our previous article, “What Is Medical Coding and Billing? How Does It Streamline a Hospital’s Financial Performance?” Ensuring the encounter was coded correctly with the right terminology is essential for correct payment and an accurate patient medical history.

Read More

The United States will begin using code U07.1 COVID-19 as of April 1 – rather than the usual effective date for new codes of October 1. This new code is being fast-tracked to allow for the urgent need of immediate data collection. Interim coding guidelines from the CDC are still to be used between now and the effective date (CDC, 2020). Review our previous article, “Coding for Coronavirus Outbreak: Interim Guidance from the CDC,” for additional information about code U07.1.

Read More
ICD 10 code for vaping

The WHO Family of International Classifications (WHOFIC) Network Classification and Statistics Advisory Committee (CSAC) convened to establish a new emergency code to be used by WHO. This new emergency code, U07.0 – Vaping-related disorder, was implemented and valid for immediate use as of September 24, 2019, for ICD-10. In the United States, a Supplement to the ICD-10-CM Guidelines, entitled “Coding Encounters Related to E-cigarette, or Vaping, Product Use,” was posted on October 17, 2019. The guideline update provided valuable information on the proper assigning of codes, but did not provide a unique code for vaping in ICD-10-CM.

Read More
ProFee Coding

Physician group acquisition by major health systems remains a common trend in the industry. One survey of over 8,700 physicians indicates that only 31% of physicians surveyed identify as an independent practice owner or partner as of 2018. This is down from 48.5% in 2012, a whopping 35% decrease in independently owned practices in only 6 years (Merritt Hawkins, 2018). In these acquisitions, the question remains: Who will manage the physician group?

Read More