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 […]
4 ICD-10 Changes to the Laboratory National Coverage Determination Edit Software for January 2016
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: Addition of ICD-10-CM codes N131 and N132 to the list of […]
CMS Issues 2016 HCPCS Update
The Centers for Medicare & Medicaid Services (CMS) has posted its final Level II HCPCS application determinations for 2016. Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies and services not included in the CPT-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, […]
CMS Discusses Payment Errors Associated With Co-Surgeon Modifier -62
The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast intended to clarify CMS’s existing policy regarding payments errors because of a failure to apply properly the co-surgeon modifier -62, when two or more surgeons of different specialties participate in one operative session and each separately submit claims to Medicare. […]