October Bulletin – 2022 CPT Code Updates Announced

2022 CPT Code Updates Announced The American Medical Association made more than 400 changes to the Current Procedural Terminology (CPT) Code Set for 2022. The changes take effect January 1, 2021 and include 249 new codes, 63 deletions and 93 revisions. The 2022 CPT Code Set also includes 15 vaccine codes. These codes were created […]

March Bulletin – Coding Updates for 2021

Coding Updates – 2021 The continued development of COVID-19 treatments and vaccines has prompted updates in CPT coding and billing guidelines. In addition to the updated E&M code requirements, the American Medical Association developed COVID-19 codes for each of the four coronavirus vaccines and their administrations. 91300: this is for the Pfizer vaccine only. For […]

It’s Flu Season – What you need to know!

It’s Flu Season! The 2020 – 2021 flu season is here and with COVID-19 still circulating, it’s more important than ever to get a flu vaccine. Since both the flu and COVID-19 have some similar symptoms, the Center for Disease Control and Prevention recommends that all persons 6 months and older receive a flu vaccine. […]

New CPT Code Issued for Influenza Billing

The American Medical Association has issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax. The code — CPT 90674 — went into effect on August 1, 2016, for Medicare claims. However, as the Centers for Medicare & Medicaid Services states, Medicare claims processing systems will not be able to accept the new […]

CMS Revises JW Modifier Use Policy

The Centers for Medicare & Medicaid Services (CMS) has issued a change in policy regarding the use of the -JW modifier for discarded Part B drugs and biologicals. The -JW modifier identifies “Drug amount discarded/Not administered to any patient.” Effective Jan. 1, 2017, providers will be required to: use the -JW modifier for claims with […]

Do You Understand the New Modifier -CT Reporting Guidelines?

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, […]

Free Oncology Billing and Coding Resource: 2016 Update From ASCO

The American Society of Clinical Oncology (ASCO) has published a free, downloadable resource that identifies oncology billing and coding updates for 2016. Topics discussed include the following: New CPT codes (99415 and 99416) Radiation oncology CPT updates New HCPCS codes (J8655, J7508 and J7503) Deleted HCPCS codes Filgrastim HCPCS updates Chemotherapy drugs (replacements) HCPCS codes […]

Improve Your Coding in 2016: 5 Tools to Use

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 […]