Resource AAPC articles

CMS Releases ICD-10 MS-DRG V38.1. For ICD-10-CM, this version includes new Covid 19 codes that went into effect on October 1, 2020. For ICD-10-PCS, this version includes 21 new codes for introduction or infusion of therapeutics and includes monoclonal antibodies and vaccines for COVID-19 treatment which is effective January 1, 2021.

CMS Releases ICD-10 MS-DRG V38.1

Latest update includes assignments for new COVID-19-related diagnoses and procedures. The ICD-10 Medicare Severity-Diagnosis Related Group (MS-DRG) V38.1

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[Lori]

The AAPC posted an informative article on new codes and guidelines for 2021 CPT® for cardiology. Article includes information on 8 new codes for continuous cardiac monitoring and detection (93241–93248), 3 new shunting procedure codes for congenital cardiac anomalies (33741, 33745 and +33746), and 2 new codes for cardiac assist (33995 and 33997) and revised guidelines. Also information for Zio Patch being reported as a Category 1 code 93241 and not Category III codes 0295T and 0297T effective as of January 1, 2021.

Understand and Implement New Cardiology Coding Practices​

Understand and Implement New Cardiology Coding Practices

Understand new 2021 codes and guidelines for CPT cardiology coding.

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[Lori]

If anyone is attending HEALTHCON in Dallas, TX, March 28-31, the AAPC posted an article on 10 healthy tips for this trip during the COVID-19 pandemic.

Travel Safely to HEALTHCON​

Travel Safely to HEALTHCON

Take measures to make HEALTHCON a healthy experience. AAPC's HEALTHCON 2021 is coming up quickly! I am so excited to be able to attend the in-person venue 10 tips to safely attend AAPC's HEALTHCON 2021 in person in Dallas, Texas, March 28-31.

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[Lori]

The AAPC posted an article on the U.S. Preventive Services Task Force (USPSTF) recommending changing screening for diabetes from age 40 to 35 for prediabetes and type 2 diabetes in patients who are overweight or obese.

USPSTF Reconsiders Diabetes Screening Age​

USPSTF Reconsiders Diabetes Screening Age

Is 40 too late to start diabetes screening? In a statement released March 16, 2021, the U.S. Preventive Services Task Force (USPSTF) issued new USPSTF issues new recommendation guidelines for prediabetes and type 2 diabetes screenings

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[Lori]

The AAPC posted an informative article on Pain Management and what Medicare Covers. Article includes information on what Medicare Part A, B, C and D will help pay for pain management and which therapies are included.

Pain Management: What Does Medicare Cover?

Pain Management: What Does Medicare Cover?

Alternatives to opioids bring conventional and complementary approaches together to manage chronic pain. Despite recent advances in our understanding,The impact of chronic pain and the U.S. opioid epidemic, which will shed some light on why alternative management options demand attention.

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[Lori]

The AAPC posted an article on Modifiers 58, 78, and 79. Great info on the use of Modifier 58 for anticipated procedures, Modifier 78 when complications arise, and the difference between Modifiers 78 and 79.

Append Surgical Modifiers With Confidence

Append Surgical Modifiers With Confidence

Know how to differentiate modifiers 58, 78, and 79 to ensure proper reimbursement for all procedures performed. Modifiers convey important information Know how to differentiate modifiers 58, 78, and 79 to ensure proper reimbursement for all procedures performed.

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[Lori]

RPM Coding by the Numbers​

Know when to use remote physiologic monitoring codes and what to look out for when you do.​

RPM Coding by the Numbers

Know when to use remote physiologic monitoring codes and what to look out for when you do. Along with accelerating the adoption of telehealth and Know when to use remote physiologic monitoring (RPM) codes and what to look out for when you do.

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[Lori]

Simplify the Revenue Cycle Management Process: Part 1​

Part one: Understand each step of the revenue cycle and how to minimize errors that lead to lost revenue​

Simplify the Revenue Cycle Management Process: Part 1

Understand each step of the revenue cycle and minimize errors that lead to lost revenue.

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Simplify the Revenue Cycle Management Process: Part 2​

Part two: Master the next steps in the revenue cycle by understanding the impact of patient treatment on claims.​

Simplify the Revenue Cycle Management Process: Part 2

Master the next steps in the revenue cycle in part two of this three-part series.

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Simplify the Revenue Cycle Management Process: Part 3​

Part three: Learn the ins and outs of remittance processing, denials, and patient collections.​

Simplify the Revenue Cycle Management Process: Part 3

Part three: Learn the ins and outs of remittance processing, denials, and patient collections. Successful and efficient revenue cycle management (RCM) is Learn the ins and outs of remittance processing, denials, and patient collections in revenue cycle management (RCM).

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[Lori]

Is It an Audio-Only Phone Call or a Virtual Check-in?​

Make sure your practice’s billing for communication technology-based services is compliant before the OIG comes calling.

Is It an Audio-Only Phone Call or a Virtual Check-In?

Make sure your practice’s billing for communication technology-based services is compliant before the OIG comes calling. For providers billing Make sure your practice’s billing for communication technology-based services is compliant.

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[Lori]

No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes.

Take 5: Medicare News Flash - April 2021

No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes. Catch up on the latest Medicare Part A/B news communicated Catch up on the latest Medicare Part A/B news communicated via MLN articles.

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[Lori]

J&J Vaccinations Remain Paused

J&J Vaccinations Remain Paused After Rare Clotting Cases Emerge

A pause on the use of the J&J COVID-19 vaccine should continue until more is known about a rare side effect, according to health officials.

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[Lori]

AAPC Is Advancing the Business of Healthcare Worldwide​

Learn about AAPC’s global expansion and the changes underway to support the needs of its growing international community.​

AAPC Is Advancing the Business of Healthcare Worldwide

Learn about AAPC’s global expansion and the changes underway to support the needs of its growing international community. Seeing just how far AAPC has Learn about AAPC’s global expansion and the changes underway to support the needs of its growing international community.

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[Lori]

Is MEAT Satisfying Your RAF Hunger?​

Sometimes the acronym leaves you wanting for more.

Is MEAT Satisfying Your RAF Hunger?

Sometimes the acronym leaves you wanting for more. MEAT is an acronym for Monitoring, Evaluating, Addressing/Assessing, and Treatment. The coding The coding community uses MEAT to better apply and understand an ICD-10-CM guideline that is difficult to remember.

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[Lori]

Coding for MIS Procedures With Direct Visualization​

Consider code descriptors, surgical anatomy, technology used, and type and amount of visualization.​

Coding for MIS Procedures With Direct Visualization

Know whether the procedure is open or percutaneous, also known as minimally invasive surgery (MIS).

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[Lori]

Basal Cell Carcinoma
Check your diagnosis coding for this patient encounter.

Basal Cell Carcinoma

Check your diagnosis coding for this patient encounter. A patient presents today to discuss the results of her skin biopsy. Alice came in today for a Check your diagnosis coding for this patient encounter.

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[Lori]

Take 5: Medicare News Flash – May 2021​

No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes.​

Take 5: Medicare News Flash - May 2021

No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes. Catch up on the latest Medicare Part A/B news communicated

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[Lori]

Recurrent Inguinal Hernia​

Check your diagnosis coding for this patient encounter.​

Recurrent Inguinal Hernia

Check your diagnosis coding for this patient encounter. PREOPERATIVE/POSTOPERATIVE DIAGNOSIS: Recurrent right inguinal hernia. PROCEDURE PERFORMED: Check your diagnosis coding for recurrent inguinal hernia.

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[Lori]

6 Reasons Why You Need More Than a 4-Week Online Course for Medical Billing and Coding​

6 Reasons Why You Need More Than a 4-Week Online Course for Medical Billing and Coding

How long does it take to become a medical billing and coding specialist? If you’re considering a career in medical billing and coding and have seen claims Considering a career in medical billing and coding? You can't learn all you need to know in 4 weeks.

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CCO has a great Billing course!

Certified Professional Biller CPB™ Medical Billing Course

Certified Professional Biller CPB Course. A Complete, Online Education for Learning Physician-Based Medical Billing. Certified Instructors Included.

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CCO has a billing review Blitz:

Certified Professional Biller CPB® Exam Preparation Review Blitz

Certified Professional Biller CPB® Exam Preparation Review Blitz: Review Your Knowledge of Medical Billing and Prepare for the CPB™ Exam

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CCO FREE Billing

Free CPB Practice Exam

This Free 60-Question CPB® Certified Professional Biller Practice Exam Will Prepare You With Real “Exam-Like” CPB Questions for Exam Prep.

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CCO Paid Practice exams for billing:

CPB Practice Exam

CPB Practice Exam. Carefully Crafted by CCO Certified Instructors to Prepare for the AAPC CPB Practice Exam on Medical Billing.

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Pass any exam:

How Do I Pass a AAPC Certification Exam?

The CCO Proven Process helps visualize the traditional path our students take on their way to career certification. Our unique process has been used by all our students to pass their AAPC exam on their first, second or subsequent attempts. It works for new students and veterans alike. You...

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CCO Proven Process:

CCO Proven Process - How to Pass Any AAPC Exam

The CCO Proven Process is Our Exclusive 4-Step Process for Passing Any AAPC Certification Exam including the CPC, CRC, CIC, COC and more.

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[Lori]

Know the difference when coding physical therapy (PT) and occupational therapy (OT) evaluations. Great info the APPC posted in this article regarding the differences in requirements for PT and OT evaluations.

Evaluate Your OT and PT Coding

These services may seem alike, but differences in requirements can make or break your code assignment. Physical therapy (PT) and occupational therapy (OT) Physical therapy (PT) and occupational therapy (OT) evaluations are similar, but like the two disciplines themselves, there are some distinct...

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Did you know payers have their own definition of Medical Necessity and each payer has criteria that is used to determine medical necessity? The AAPC posted a great article on medical necessity. Article includes info on how Cigna defines their medical necessity for providers and Medicare’s criteria for medical necessity.

Medical Necessity: Is It Really Necessary?

Come to terms with payers to protect your provider’s revenue stream. “Medical necessity” is an important concept for medical coders and auditors to Understanding a payer’s definition of medical necessity is essential to getting claims paid.

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The APPC posted information on new ICD-10-CM 2022 Coding Guidelines that go into effect October 1, 2021. There will be 159 additions, 25 deletions, and 27 revisions for ICD-10-CM for 2022.

Review What's New for ICD-10-CM 2022

ICD-10-CM 2022 is here. Stay on top of the latest in diagnosis coding by reviewing this chapter-by-chapter summary of the changes effective October 1.

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SOAP format could be easier for providers to document with the new 2021 office and other outpatient E/M services (CPT® 99202-99215) guidelines for medical necessity. The AAPC wrote an article on How Clean Up E/M Documentation with SOAP:

Clean Up E/M Documentation With SOAP

SOAP documentation has been a standard for nearly 50 years, allowing clinicians to clearly document patient care and treatment.

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Great info the AAPC posted on coding L8679 Implantable neurostimulator, pulse generator, any type, with information on how to report Level II code L8679 and incorrect billing of Level II code L8679.

Improper Billing of P-Stim Devices Leads to More Fraud Settlements

Two chiropractic practices agree to pay over $800,000 to resolve liability for the alleged improper billing of P-Stim devices. In the latest case of Two chiropractic practices agree to pay over $800,000 to resolve liability for the alleged improper billing of P-Stim devices.

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Great article the AAPC posted on Modifier 59 and NCCI edits.

Modifier 59: Don’t Stop! Yield and Investigate

Yield and investigate the possibility of using modifier 59 to unbundle a code pair. A short investigation could result in a higher reimbursement.

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Great article the AAPC posted on the False Claims Act (FCA) and the changes to the FCA under the Fraud Enforcement Recovery Act of 2009 (FERA) and the Affordable Care Act (ACA).

The Evolution of Fraud Liability

Nothing stays the same, including the way the feds interpret the law. The False Claims Act (FCA) has become the government’s fraud enforcement vehicle of The FCA has become the government’s fraud enforcement vehicle of choice.

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[Lori]

Feds Act to Regulate Surprise Billing​

Interim final rule lays groundwork for implementing No Surprises Act by 2022.

Feds Act to Regulate Surprise Billing

Interim final rule lays groundwork for implementing No Surprises Act by 2022. On July 1 the U.S. Department of Health and Human Services (HHS), Labor, and Interim final rule lays groundwork for implementing No Surprises Act by 2022.

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[Lori]

CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction​

Proposed rule improves payment rates, incentives, and ESRD treatment choices.

CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction

CMS proposes updates Medicare payment rates for renal dialysis services, changes the ESRD QIP, and modifications to the ESRD ETC Model.

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