2021 updates for Prolonged services CPT codes

In 2021, there will be two sets of time rules that govern E/M services, one set for office/outpatient codes 99202—99215, and one set for hospital, observation, ED, nursing facility, home, and domiciliary care services. When selecting an office visit code, the clinician may use either the new medical decision making definitions, or total time spent … Read more

Finally AMA releases 2021 E/M CPT code set

American Medical Association has released the 2021 E/M CPT code set which includes major changes in 2021 Current Procedural Terminology (CPT). This will simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services. The AMA described the changes to the CPT codes as the “first major overhaul in more than … Read more

New Modifier 96 and 97 for Medical coders

New Modifiers 96 and 97 in 2018 for Medical coders

In 2018, modifer 96 & 97 was introduced to medical coders. Coders use Modifier 96 and 97 as for Habilitative and Rehabilitative services. Below is the full description for these new modifiers. Also, CPT code 97129 (base code) and 97130 (add-on code) are time-based codes which have replaced CPT code 97127 and HCPCS G-code G0515. 97129 … Read more

Best coding tips for Pressure and Non-Pressure Ulcers

Best coding tips for Pressure and Non-Pressure Ulcers

Basics about Pressure and Non-Pressure Ulcers ICD 10 codes A Pressure ulcer is also known as a decubitis ulcer, pressure sore, or bedsore. It’s an open wound on your skin. Decubitis ulcers often occur on the skin covering bony areas. The most common places for a decubitis ulcer are your  elbow, heels, hips, ankles, shoulders, … Read more

ZPIC audit process: Know Everything about it

Basic of ZPIC Audit Process ZPIC stands for Zone Program Integrity Contractor audit. The ZPIC audit helps in looking for frauds which can be referred to the Department of Health & Human Services (HHS) Office of Inspector General (OIG) for consideration of civil or criminal prosecution. ZPICs can go after everything for audit from single-doc … Read more

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