Medical Billing and Coding Healthcare Blog

Proper medical coding is critical for many reasons. They include receiving proper payment for services rendered, limiting denials and maintaining compliance with payor rules.

Throughout 2015, PGM Billing launched a number of practice management tools that help ensure proper coding. These tools are free to access and use, and can be shared with coworkers and colleagues.

The tools are as follows:

  1. Medicare CPT code lookup tool provides users the ability to perform CPT code searches to obtain the Medicare relative value payment associated with a specified code and geographic region.
  2. CPT coding app performs code searches to obtain the Medicare relative value payment associated with a specified code and geographic region. It is available for free from the iTunes app store.
  3. ICD-9 to ICD-10 Code Conversion Tool converts ICD-9 to ICD-10 codes (and vice versa) by simply selecting the conversation type followed by the code. It also includes the ICD-10 Code Lookup Tool, which provides the option to search for just an ICD-10 code via code or keyword.
  4. ICD-9 to ICD-10 Crosswalks address some of the most frequently used ICD-9 codes converted to their ICD-10 equivalent(s) in more than a dozen common specialties: allergy, anesthesia, cardiology, chiropractic, dermatology, emergency medicine, gastroenterology, mental health, nephrology, orthopedics, otolaryngology, pain management, primary care and urology.
  5. HCPCS Code Lookup Tool provides users the ability to perform a HCPC codes lookup to obtain the correct code and description a user is looking for. Users may search using either the complete or partial HCPCS code as well as any number of keywords used to describe the specified code.

Access the practice management tools by clicking here. PGM offers additional, free coding resources available through the PGM website, including a robust and frequently updated healthcare blog and a section of the site dedicated to providing an overview and explanation of ICD-10.

The Centers for Medicare & Medicaid Services has announced four changes that will be included in the January 2016 quarterly release of the edit module for clinical diagnostic laboratory services.

The changes being made to the National Coverage Determinations (NCD) code lists as follows: 

  1. Addition of ICD-10-CM codes N131 and N132 to the list of ICD-10-CM codes that are covered by Medicare for the Urine Culture, Bacterial (190.12) NCD.
  2. Addition of ICD-10-CM code I481 to the list of ICD-10-CM codes that are covered by Medicare for the Partial Thromboplastin Time (PTT) (190.16) NCD.
  3. Addition of ICD-10-CM code S069X0A to the list of ICD-10-CM codes that are covered by Medicare for the Prothrombin Time (PT) (190.17) NCD.
  4. Addition of ICD-10-CM code I481 to the list of ICD-10-CM codes that are covered by Medicare for the Thyroid Testing (190.22) NCD.

These changes are effective for services furnished on or after October 1, 2015.

Those providing laboratory billing services need to be aware of these changes.

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