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]

Differentiating HCPCS Levels I and II Code Sets​

Deciding which code to use starts with determining each payer’s policy.​

Differentiating HCPCS Levels I and II Code Sets

HCPCS has two principal subsystems, referred to as Level I and Level II.

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[Lori]

Billing Sports Physicals: GAME ON!​

Correct coding and proper payment require strategy and teamwork.​

Billing Sports Physicals: GAME ON!

PPE, or sports physical, is a valuable tool schools rely on to identify potentially life-threatening conditions as well as other issues that could pose a threat to a student’s health.

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[Lori]

Audits Are the Heartbeat of Your Compliance Program​

Here’s what you need to know to protect your healthcare entity’s revenue stream.​

://www.aapc.com/blog/80429-audits-are-the-heartbeat-of-your-compliance-program/

 

[Lori]

Take 5: Medicare News You Can Use – July 2021​

OIG Audit Uncovers Overpayments for TCM Services​

Take 5: Medicare News You Can Use – July 2021

Get caught up on the medical coding and billing news that could affect payment for your professional claims. We cut out the rhetoric and give it to you Get caught up on the medical coding and billing news that could affect payment for your professional claims.

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[Lori]

CMS Proposes MPFS Payment Policies for 2022​

CMS Proposes MPFS Payment Policies for 2022

The effects of COVID-19 are still being felt in the states and influencing the Centers for Medicare & Medicaid Services’ (CMS’) decisions for policy The effects of COVID-19 are evident in the 2022 Medicare Physician Fee Schedule (MPFS) proposed rule.

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[Lori]

OIG Discovers $4.4 Million Overpayment in State Claims

A recent audit on Arkansas MMIS private contractor costs reveals millions in incorrect claims and inappropriate payments.

OIG Discovers $4.4 Million Overpayment in State Claims

A recent audit on Arkansas MMIS private contractor costs reveals millions in incorrect claims and inappropriate payments. Last month the Office of A recent OIG audit on Arkansas MMIS private contractor costs reveals millions in incorrect claims and inappropriate payments.

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[Lori]

CAR-T Coding Update

C9076 is the newest addition to the list of HCPCS Level II codes for CAR-T therapies, effective July 1.

CAR-T Coding Update

C9076 is the newest addition to the list of HCPCS Level II codes for CAR-T therapies, effective July 1. Learn the latest changes to reporting products and

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[Lori]

AAPC Social Hour: Jean Pryor on Careers

Tune in for some words of wisdom from a coding professional.

AAPC Social Hour: Jean Pryor on Careers

Tune in for some words of wisdom from a coding professional. During a Facebook Live broadcast, Aug. 11, moderator and AAPC Social Media Manager Alex Joining AAPC Alex for Social Hour, Aug. 11, was Jean Pryor, CPC,CPCO, CPB, CPMA, CPC-I, CRC, CIMC, CCS-P, CHAP, AAPC Fellow.

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[WhitneyH_24046]

Thanks Lori for providing all these helpful articles!

 

[Lori]

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs​

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity.

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On CMS’ recent proposed actions seek to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity.

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[Lori]

2022 IPPS Final Rule Boosts Hospital Reimbursement​

CMS estimates a $2.3 billion increase in hospital payments next year due, in part, to a 2.5 percent bump in reimbursement rates under Medicare’s IPPS.

2022 IPPS Final Rule Boosts Hospital Reimbursement

CMS estimates a $2.3 billion increase in hospital payments next year due, in part, to a 2.5 percent bump in reimbursement rates under Medicare’s IPPS. On

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[Lori]

Take 5 – Medical Coding News – August 2021​

What are the latest code changes? Get the facts, fast.​

FDA Approves COVID-19 Vaccine​

New Codes for COVID-19 Monoclonal Antibodies​

2021-22 Seasonal Flu Vaccine Pricing​

Take 5 – Medical Coding News – August 2021

What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II new guidance for a COVID-19 vaccine; new codes for COVID-19 therapeutic injections; and 2021-22 influenza vaccines

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[Lori]

Brush Up on Outpatient Billing and Coding Basics

The shift to outpatient services puts billers and coders with an understanding of the OPPS in demand.

Brush Up on Outpatient Billing and Coding Basics

The shift to outpatient services puts billers and coders with an understanding of the OPPS in demand. Hospital outpatient services are all services The shift to outpatient services puts billers and coders with an understanding of the OPPS in demand.

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[Lori]

Coding Ovarian and Other Gynecologic Cancer Treatments​

Start by asking the right questions

Coding Ovarian and Other Gynecologic Cancer Treatments

Start by asking the right questions. Coding for gynecologic oncology procedures can be complicated. Procedure codes differ depending on whether the Start coding ovarian and other gynecological cancer treatments by first asking the right questions.

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[Lori]

Prior Authorization for Non-Emergent Ambulance Transports Back on Track

Find out what you’ll need to do to get these claims paid.
Medicare Part B Coding and Coverage
When Will Suppliers Have to Comply with Prior Authorization of RSNAT?
What Is the Purpose of Prior Authorization?
How Do I Obtain Prior Authorization?
Certain Requirements Remain on Pause Due to COVID-19

Prior Authorization for Non-Emergent Ambulance Transports Back on Track

Find out what you'll need to do to get these claims paid. Expansion of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Expansion of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports (RSNAT) will begin as early as Dec. 1.

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[Lori]

New rule for surprise billing.

Additional protections & addresses indepentdent dispute resolution process.

Good Faith estimates, resolution & review with further protections.

Next Interim Final Rule for Surprise Billing Ban Released

Second interim final rule implements additional protections and addresses the independent dispute resolution process. On Sept. 30, 2021, the Department of Second interim final rule for surprise billing ban implements additional protections and addresses the independent dispute resolution process.

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[Lori]

Are you ready for the 21/22 flu season?

Vaccine codes, payment allowances & billing guidelines.

Coding, expert recommendations & what's going around this year?

Update: 2021-2022 Flu Vaccine Information

Time to make sure your practice is current on the 2021-2022 codes and payment allowances for flu vaccine and administration. With the novel coronavirus

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[Lori]

COB rules.

Determine when care may be covered by another payer.

Recognize when a COB is needed, patients with Medicare.

Other circumstances for COB>

Prevent CO-22 Claim Denials

Follow COB rules to determine when care may be covered by another payer. Coordination of benefits (COB) can be described as when two or more insurance Follow COB rules to determine when care may be covered by another payer.

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[Lori]

See what's new in the Medicare Processing manual.

What instigated CR12377 Udates?

Chapters, 3, 18, 32.

CR12377 Updates Coding in Medicare Claims Processing Manual

Code updates to chapters 3, 18, and 32 of the Medicare Claims Processing Manual prompted the release of CR12377 by CMS Oct. 13.

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[Lori]

FTC cautions Apps Fall Under Health Breach Notification Rule.

As more health apps flood the market, app developers need to be aware of their responsibilities to consumers.

Old Rule, New Technologies
Who Does This Cover?
What is the Impact?

Apps Fall Under Health Breach Notification Rule, Cautions FTC

As more health apps flood the market, app developers need to be aware of their responsibilities to consumers. The U.S. Federal Trade Commission (FTC) FTC clarifies health app requirements under the Health Breach Notification Rule.

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