Medical Billing and Coding Healthcare Blog

As we previously discussed, the Centers for Medicare & Medicaid Services and Centers for Disease Control and Prevention indicated they will add about 1,900 diagnosis codes and more than 3,600 hospital inpatient procedure codes to the ICD-10 coding system.

After these codes are finalized, they will go into effect October 1.

Now the American Health Information Management Association (AHIMA) is pushing for changes to a number of these ICD-10-PCS codes because, as a Journal of AHIMA column notes, "...many of the new ICD-10-PCS codes deal with cardiovascular system devices and procedures, while ICD-10-CM additions were much broader in scope."

AHIMA has requested changes to codes in the following categories:

  • SPY Fluorescence Vascular Angiography (FVA)
  • Oxidized Zirconium on Polyethylene Bearing Surfaces for Hip and Knee Arthroplasty
  • Spinal Fusion with Nano-Textured Surface
  • Intravenous Administration of Andexanet Alfa
  • Insertion of Endobronchial Coils
  • Hematopoietic Cell Transplant Donor Type
  • Minimally Invasive Aortic Valve Replacement
  • Branched Endograft Repair of Common Iliac Aneurysm
  • Intravenous Administration of Defitelio (defibrotide)
  • Administration of VISTOGARD (uridine triacetate)
  • Insertion of Spinal Bracing and Distraction System
  • Application of Biologic Wound Matrix
  • Total Anomalous Pulmonary Venous Return (TAPVR)

AHIMA also recommended changes to ICD-10-CM codes in the following categories:

  • Classification of Myocardial Infarction
  • Congenital Sacral Dimple
  • Postoperative Seroma
  • Addenda

To read AHIMA comments regarding ICD-10-PCS codes, click here.

To read AHIMA comments regarding ICD-10-CM codes, click here.

For assistance with ICD-10, check out the many tools developed by PGM Billing, one of the nation's leading coding and medical billing companies. Practice management resources include an ICD-9 to ICD-10 code conversion tool, ICD-10 code lookup tool, ICD-9 to ICD-10 crosswalks, and ICD-10 training and education. Want to know why more healthcare organizations are choosing PGM for assistance with billing, practice management, EMR services and more? Contact PGM today!

In an MLN Matters article published late last year, the Centers for Medicare & Medicaid Services (CMS) discussed the creation of modifier -CT (computed tomography services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association (NEMA) XR-29-2013 standard).

Effective for claims submitted on or after January 1, 2016, CMS now requires the use of -CT for applicable CT scans furnished on non-NEMA Standard XR-29-2013-compliant equipment. Providers must append it to codes for CT scans on services furnished on equipment that do not adhere to this NEMA standard.

The codes are as follows:

  • 70450–70498
  • 71250–71275
  • 72125–72133
  • 72191–72194
  • 73200–73206
  • 73700–73706
  • 74150–74178
  • 74261–74263
  • 75571–75574
  • Successor codes

According to the American College of Radiology (ACR), CT scanners meeting the XR-29 standard have the following:

  • DICOM-compliant radiation dose structured reporting
  • Dose check features
  • Automatic exposure control
  • Reference adult and pediatric protocols

As CMS notes, a payment reduction of 5% will apply to CT services furnished using equipment that is inconsistent with the CT equipment standard and for which payment is made under the physician fee schedule. The payment reduction increases to 15% in 2017 and subsequent years.

For more information on modifier -CT, see the following:

For assistance with lab billing and coding, contact PGM Billing, one of the nation's leading providers of medical billing services.

X