ICD-10-CM Updates for FY 2025 By CMS

Get ready for some thrilling updates! The ICD-10-CM code set has just been revamped for fiscal year (FY) 2025, and the new changes are live on the Centers for Medicare & Medicaid Services (CMS) website as of July 3. These 2025 ICD-10-CM codes are to be used for resident stays occurring from October 1, 2024, … Read more

2025 CPT codes changes Anticipated for Medical coders

2025 CPT codes changes Anticipated for Medical coders

For the 2025 edition of the Current Procedural Terminology (CPT) code set, several revisions in radiology codes have been proposed. These updates include the introduction of new codes for reporting various procedures such as MRI-monitored transurethral ultrasound ablation of the prostate (TULSA), transcranial Doppler studies, percutaneous radiofrequency (RF) ablation of the thyroid, fascial plane blocks, … Read more

AWV vs. E/M Visits: Should You Combine or Separate Them?

When deciding whether to perform an Annual Wellness Visit (AWV) in conjunction with an Evaluation and Management (E/M) office visit or as two separate appointments, healthcare providers need to weigh several factors. Each approach has distinct advantages and challenges for both the patient and the provider. 1. Pros of Combining the AWV and E/M Visits … Read more

Time-Based Coding for Office and Outpatient Visits

When coding office or outpatient visits based on time, it is essential to consider the total minutes a physician or qualified healthcare professional spends on various activities, including time spent updating the patient’s medical record. These activities must take place on the same calendar date as the face-to-face encounter. Key Points about Time-Based Coding: Time-based … Read more

Mastering the 2025 Telemedicine Codes: Key Insights and Best Practices for Real-Time Encounters

Mastering the 2025 Telemedicine Codes: Key Insights and Best Practices for Real-Time Encounters

Basics of 2025 Telemedicine Codes The 2025 CPT manual introduces 16 new telemedicine codes designed for real-time encounters, which are divided into those conducted via synchronous audio-video connection and audio-only connection. These codes mirror the structure of office and outpatient evaluation and management (E/M) codes. It is essential to note that the services must be … Read more

Navigating Lymphoma Remission: A Guide to 2025 ICD-10-CM Coding

Researchers have dedicated decades to advancing treatments for individuals diagnosed with malignant neoplasms, commonly referred to as cancer. Their efforts have yielded significant progress, as evidenced by the increasing number of patients diagnosed with this formidable disease who are living longer, healthier lives. In 2025, further proof of these advancements will be seen with the … Read more

Sample coded report for CPT 19083 & 38505

Procedure: Ultrasound-guided core needle biopsy right breast at 2 sites, ultrasound-guided core needle biopsy left axillary lymph node, right diagnostic mammogram HISTORY: 33-year-old woman presents with history of a 25 mm mass of the right breast 10 o’clock position, 7 cm from nipple (site A), 5 mm mass of the right breast 9 o’clock position, … Read more

CPT 93886 sample coded report

Basics of CPT code 93886 CPT Code 93886 is Transcranial Doppler study of Intracranial arteries; complete study. It requires bilateral insonation and waveforms from all major vessels with the cranium through the Temporal acoustic window. These vessels include the Middle Cerebral Artery (MCA), Anterior Cerebral Artery (ACA), and Posterior Cerebral Artery (PCA). The Posterior window … Read more

A Sneak Peek at the Expanded CPT Codes for 2025

The 2025 expansion of CPT (Current Procedural Terminology) codes is poised to bring significant changes to primary care practices, with the introduction of 270 new codes, 38 revisions, and 112 deletions. These updates, effective January 1, 2025, are crucial for providers to review in advance to ensure timely reimbursement. On September 1, the American Medical … Read more

Understanding G2211: CMS Guidance on Billing Office and Outpatient E/M Visit Complexity

In January 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance regarding the implementation of HCPCS add-on code G2211. This code is designed for office and outpatient (O/O) evaluation and management (E/M) visits that are inherently complex due to the medical care required. G2211 applies when care involves continuous collaboration for a patient’s … Read more

Essential Tips for Correctly Using Modifier -FS in Split/Shared E/M Visits

As modifier -FS approaches its third year of active status, it’s important to understand the correct application of this modifier, which dictates payment for split/shared E/M visits. Since its introduction by CMS in January 2022, the modifier has become crucial for accurate billing, helping to prevent overpayments, underpayments, and compliance issues. Here are key tips … Read more

Medicare Expands Coverage for Behavioral Health Services, Including Digital Mental Health Treatments

The Centers for Medicare & Medicaid Services (CMS) has finalized several changes that significantly expand the scope of behavioral health services, incorporating new coverage for digital treatments and crisis intervention codes. These updates aim to enhance access to behavioral health care, especially in digital and remote settings, and address evolving patient needs. Key Updates to … Read more

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