"Diagnosis Coding" & "Preventive Medicine" Articles

Click on the title to see the article summary and a link to the full article.

October 1st, 2020

New Codes for Cytokine Release Syndrome (CRS)

By Wyn Staheli, Director of Research | Published October 1st, 2020 - Last Review/Update October 6th, 2020

New codes for Cytokine Release Syndrome (CRS) are effective October 1, 2020 based on the grade/severity of the symptoms. This article covers the new grading scales.

June 10th, 2020

MEGA - NCCI Edit Changes - WHO Knew?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published June 10th, 2020

There was no huge announcement when CMS released new files in April. The files that were released on April 7, 2020, actually replaced files to update the NCCI edits on Procedure to Procedure (PTP) edits and Medically Unlikely Edits (MUE). The updated files included; 291,902 Deleted Procedure to Procedure (PTP) edits 197 Deleted Medically Unlikely ...

March 24th, 2020

"What is the ICD-10 code for...?" - Search Smarter With Find-A-Code Tools

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published March 24th, 2020

Do you still find yourself searching the internet for an ICD10 code? Medical coders often type into their search engine, what is the ICD10 code for ... and a specific diagnosis code, to avoid repeatedly dragging out the incredibly large ICD10 codebook. Ironically, some of the most commonly searched ICD10 diagnoses include: ...

February 19th, 2020

Q/A: Did Noridian Stop Covering the M99.0- Codes?

By Wyn Staheli, Director of Research | Published February 19th, 2020

Question: I heard that Medicare Noridian Jurisdiction F (Alaska) has been denying claims with M99.00, M99.01, M99.02, M99.03 etc codes when billed with the CMT CPT codes. Did Medicare change their policy?

older articles ↓

October 7th, 2019

Hypertension & ICD-10

By Raquel Shumway | Published October 7th, 2019

Hypertensive Diseases and ICD-10. Helps and examples for these codes.

October 1st, 2019

The New ICD-10-CM Code Updates Are Here — Are You Ready?

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 1st, 2019

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases. Chapter 2: ...

September 30th, 2019

Vaccine Administration - When The Right Vaccine Code is Not Enough

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published September 30th, 2019

Understanding how to apply immunization administration codes properly will support correct reimbursement for vaccinations. Reporting the right vaccine code alone is not enough to guarantee proper billing. The majority of the time, providers can charge for the vaccine/product as well as the administration of the vaccine; always consult your payer ...

September 9th, 2019

Chiropractic 2020 Codes Changes Are Here

By Wyn Staheli, Director of Research | Published September 9th, 2019

There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing?

August 13th, 2019

Healthcare Common Procedure Coding System (HCPCS)

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 13th, 2019

There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ...

July 9th, 2019

The Importance of Medical Necessity

By Marge McQuade, CMSCS, CHCI, CPOM | Published July 9th, 2019

ICD-10-CM codes represent the first line of defense when it comes to medical necessity. Correctly chosen diagnosis codes support the reason for the visit as well as the level of the E/M services provided. The issue of medical necessity is one of definitions and communication. What is obvious to the ...

April 23rd, 2019

What is Medical Necessity and How Does Documentation Support It?

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published April 23rd, 2019

We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

March 27th, 2019

Pain Codes in ICD-10-CM

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 27th, 2019

When coding with ICD-10-CM, pain codes can be found in different sections: The Body System affected or site-specific pain codes, such as Low Back Pain M54.5, can be found in Chapter 13. Diseases of the Musculoskeletal system (M00-M99). Other examples might be ocular pain H57.1, found in Chapter 7. Diseases of ...

November 8th, 2018

Diagnosis Coding for Cardiology

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published November 8th, 2018

Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections: Acute rheumatic fever (I00-I02)Chronic rheumatic heart diseases (I05-I09)Hypertensive diseases (I10-I16)Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)Other forms of heart disease (I30-I52)Cerebrovascular diseases (I60-I69)Diseases of arteries, ...

November 1st, 2018

CMS: Medicare Diabetes Prevention Program Expanded Model

By Find-A-Code | Published November 1st, 2018

CMS announces the Medicare Diabetes prevention program is now a new covered service. Per a recent MLN news release. Medicare Beneficiaries will be notified in 2019 in a Medicare handout. Diabetes affects more than 25 percent of Americans aged 65 or older, and its prevalence is projected to increase approximately...

October 19th, 2018

Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder

By Wyn Staheli, Director of Research | Published October 19th, 2018 - Last Review/Update December 19th, 2018

The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association's Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and ...

September 24th, 2018

2019 Code Changes are Just Around the Corner - Are You Ready?

By Wyn Staheli, Director of Research | Published September 24th, 2018 - Last Review/Update January 28th, 2019

The leaves are beginning to change and it’s time once again for the annual code changes for 2019. ICD-10-CM codes are out and will be effective October 1, 2018. CPT code changes also just came out and will be effective January 1, 2019. The ChiroCode DeskBook and ICD-10-CM Coding for Chiropractic books have been ...

July 17th, 2018

Understanding the Level of Preventative Services (Grades and Suggestions)

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 17th, 2018

It is essential for providers, clinicians, and other users to understand the importance of providing preventative services. The U.S. Preventative Services Task Force (USPSTF) has recommendations and has applied Grade Definitions as a suggested resource to imply the significance and strength of preventative services. The following definitions apply to recommendations ...

June 7th, 2018

New on our TOPICS Page - "Preventive Medicine Coding and Billing Information"

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published June 7th, 2018

There is a lot of information available for you to utilize on our Topics pages. We have recently added a Preventative Medicine TOPICS page (under subjects), as per customers' request, for searching Preventative Codes. We're made it easy to locate services required under the Affordable Care Act for reporting preventive services. ...

May 30th, 2018

Coding for Strains in ICD 10

By BC Advantage | Published May 30th, 2018 - Last Review/Update June 4th, 2018

According to the National Institutes of Health, a review was carried out on 20 patients who had a pectoralis major muscle repair between 2003 and 2011, and the results were as follows....

May 22nd, 2018

AMA vs Medicare rules and the use of the PT modifier

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published May 22nd, 2018

Be sure to review the specific payer policy you are submitting claims to. Medicare’s policy requires the use of a different code when a screening colonoscopy becomes a diagnostic procedure requiring you to bill with CPT code 00811 when treating a Medicare Beneficiary. The use of the PT modifier is ...

May 9th, 2018

Preventive Medicine: General Procedures

By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update July 30th, 2018

Preventive Medicine Topics Page General Procedures Procedure Codes 36415: Collection of venous blood by venipuncture 90471: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) 90472: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List ...

May 9th, 2018

Preventive Medicine: Links and Resources

By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update July 30th, 2018

Back to Topic Page References Kaiser Permanentehttps://provider.ghc.org/open/coverageAndEligibility/groupHealthPlans/preventive-services-guidelines.pdf Medicare Learning Networkhttps://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS-QuickReferenceChart-1TextOnlywithICD9.pdf AAFP - ICD-10 Simplifies Preventive Care Coding, Sort Of - Cindy Hugheshttps://www.aafp.org/fpm/2014/0700/oa1.html List of ACA Preventive Services and CPT Codes - STDshttp://stdtac.org/wp-content/uploads/2014/06/List-of-ACA-Preventative-Services-and-CPT-Codes-_STDTAC.pdf Additional Links and Resources ACA guidelines as per healthcare.govhttps://www.healthcare.gov/coverage/preventive-care-benefits/ Preventive Medicine Listhttps://www1.ghc.org/static/pdf/public/formulary/aca-list.pdf ...

May 9th, 2018

Preventive Medicine: Alcohol Misuse Screening & Counseling

By Find-A-Code™ | Published May 9th, 2018 - Last Review/Update July 30th, 2018

Preventive Medicine Topics Page // Alcohol Misuse Screening and Counseling Procedure Codes G0442: Annual alcohol misuse screening, 15 minutes G0443: Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes 99408: Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to ...

May 9th, 2018