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Basics of Body Mass Index (BMI) ICD-10 code BMI describes patients’ body weight in consideration of their height. The patient’s weight in kilograms is divided by the square of the patient’s height in meters (kg/m²). A high BMI can be an indicator of overweight or obesity; a low BMI may indicate cachexia or malnutrition. Some people, … Read more
List of Status Indicators A = Active code. Medicare pays these codes separately under the physician fee schedule (PFS), if covered. Codes with this status include RVUs and payment amounts. The presence of an A indicator doesn’t mean that Medicare has made a national coverage determination about the service. A/B MACs (B) stay responsible for … Read more
ICD 10 coding guidelines has many different instructional notes which help us to follow general coding guidelines. For example, the Excludes 1 and Excludes 2 notes which are newly introduced in ICD 10, tells us whether to code these codes together or not. The same way, we have lot of codes in ICD 10 code … Read more
Basics for CPT code 99497, 99498, 1123F & 1124F Advance care planning (ACP) involves learning about and considering the types of decisions that will need to be made at the time of an eventual life-ending situation and what the patient’s preferences would be regarding those decisions. Discussions between the patient’s physician(s) or other qualified health … Read more
Medicare rates cover hospital outpatient services. OPPS covers hospital outpatient X-rays, emergency department visits, and partial hospitalization. Medicare rates determine ASC payment. The ASC Payment System pays for covered surgical procedures and ASC facility services. CMS updates OPPS/ASC regulations annually in one rule, with comment periods before implementation. The ACS is interested in CMS’ OPPS … Read more
The risk adjustment phase-in for Medicare Managed Care Organizations (MCOs) was completed in 2007. Medicare Advantage was created in 1997. Chronic and cumulative “hierarchical condition categories” (HCCs) form the risk adjusted reimbursement model. Physician reimbursement has been fee-for-service. Patients pay doctors. Under this structure, CPT codes and their relative values determine reimbursement, and ICD-9 diagnostic … Read more
What is a Pathological Fracture? Fractures can be coded as traumatic or non-traumatic fractures. As we grow older, our bone density starts decreasing. Due to decrease in density, we may suffer from osteopenia or osteoporosis. Due to less bone density in old age, the bones get fractures even with a small injury. Sometimes even doing … Read more
Basics for CPT code 76706 Today we will learn about the coding guidelines for CPT code 76706 for screening exam of aorta. CPT Code 76706 had replace the old HCPCS code G0389, Ultrasound B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA) screening,in 2017. A procedure is performed using ultrasound (US) to screen … Read more
Their has been lot of confusion with the coding of B12 injection. This has happened because many coders are not aware of use HCPCS codes. Each CPT or HCPCS code has particular guideline and coder should always follow those guidelines. If you do not follow guidelines then your coded procedure might be not paid or … Read more
Basics of CPt code 99244, 99242, 99243 and 99245 For the Current Procedural Terminology (CPT) 2023 code set, the E/M consultation subsection guidelines and code descriptors were significantly revised as part of the continuous effort to simplify administrative processes when providing E/M services. A consultation is defined in the CPT 2023 code set as “a … Read more