Topics & Specialty Resources

articles, webinars, tips, links and other resources for medical coding, reimbursement and compliance


Facilities & Organizations - ACOs, Hospitals, etc.Payers - Medicare, Medicaid, BC/BS, Aetna, etc.Specialties - Cardiology, ENT, Family Practice, etc.States - State specific informationSubjects - Audits, E&M, HIPAA, Practice Management, etc.


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recent articles

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Good and Bad News Regarding the 2021 Medicare Physician Fee Schedule

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When the proposed Medicare Physician Fee Schedule came out last year, it really got everyone worried. In a time where we are all facing issues related to COVID, this seemed like a really big problem. Professional organizations lobbied and everyone tried to stop the proposed changes, and the 10.2% decrease didn’t happen, but other changes will still be taking place. So how bad is it really and how will it affect your organization?

tags  Specl: Chiropractic    Specl: Physical Medicine|Physical Therapy    Topic: CPT Coding    Topic: Fees    Topic: HCPCS Coding    Topic: Practice Management    Topic: Reimbursement   

Instructions for Looking up IOM References in innoviHealth's HCPCS Publication

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These instructions help owners of innoviHealth's HCPCS Coding for 2021 book access the references to Medicare's Internet-only Manuals (IOMs) which are copies of official program instructions, policies, and procedures that are based on statutes, regulations, guidelines, models, and directives.

tags  Topic: HCPCS Coding    Topic: Procedure Coding    Topic: Supply Coding   

HIPAA Penalty Changes

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On January 5, 2021, H.R. 7898 was signed into law by President Trump. This new law modifies the HITECH Act such that when an organization experiences a breach, fines and/or penalties may be reduced if (for at least a year) they have instituted “recognized security practices” as defined within the law.

tags  Specl: All Specialties    Topic: Compliance    Topic: HIPAA   

ICD-10 Code Updates for January 1st

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Be aware that new ICD-10-CM and ICD-10-PCS codes took effect on January 1, 2021. Rarely have ICD-10-CM codes been released in January, but as you may have guessed, these changes are in relation to COVID-19. The information in this article will help your organization understand these changes.

tags  Topic: Code Updates    Topic: COVID-19    Topic: ICD10CM Coding    Topic: ICD10PCS Coding   

CMS Reduces the Exchange User Fee to Support Lower Premiums for the Consumer

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It has been no secret that Americans have been complaining about the high cost of health plans since implementation of the Affordable Care Act (ACA). Premiums and deductibles have skyrocketed and in many states are equal to or exceed the cost of their rent or mortgage payments. As such, most ...

tags  Loc: All Locations    Payer: All Payers    Specl: Risk Adjustment|HCC Coding    Topic: Risk Adjustment   

CMS Final Rule Changes E/M Reporting Guidelines

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Just when we thought we had figured out Evaluation and Management (E/M) reporting for 2021, CMS released their final rule and now we will need to make some adjustments. While CMS stated that they were adopting the AMA guidelines for E/M office or other outpatient services, they did make a few changes.

tags  Topic: CPT Coding    Topic: E+M Documentation and Coding    Topic: HCPCS Coding    Topic: Modifier Coding    Topic: Procedure Coding   

CMS Final Rule Changes E/M Reporting Guidelines

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Just when we thought we had figured out Evaluation and Management (E/M) reporting for 2021, CMS released their final rule and now we will need to make some adjustments. While CMS stated that they were adopting the AMA guidelines for E/M office or other outpatient services, they did make a few changes.

tags  Specl: Chiropractic    Topic: CPT Coding    Topic: E+M Documentation and Coding    Topic: HCPCS Coding    Topic: Modifier Coding   

ICD-10-CM 2021 Codes for your Specialty

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1. Certain infectious and parasitic diseases (A00-B99) Code:            Description:A84.81          Powassan virus diseaseA84.89          Other tick-borne viral encephalitisB60.00          Babesiosis, unspecifiedB60.01          Babesiosis due to Babesia microtiB60.02          Babesiosis due to Babesia duncaniB60.03        ...

tags  Specl: Laboratory|Pathology    Specl: Neurology|Neurosurgery    Specl: Primary Care|Family Care    Topic: ICD10CM Coding   

ICD-10-CM 2021 Codes for your Specialty

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13. Diseases of the musculoskeletal system and connective tissue (M00-M99) Code:            Description:M05.7A          Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvementM05.8A          Other rheumatoid arthritis with rheumatoid factor of other specified siteM06.0A        ...

tags  Specl: General Surgery    Specl: Orthopedics    Specl: Radiology    Specl: Rheumatology    Topic: ICD10CM Coding   

ICD-10-CM 2021 Codes for your Specialty

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15. Pregnancy, childbirth and the puerperium (O00-O9A) Code:            Description:O34.218        Maternal care for other type scar from previous cesarean deliveryO34.22          Maternal care for cesarean scar defect (isthmocele) O99.891        Other specified diseases and conditions complicating pregnancyO99.892        Other ...

tags  Specl: Obstetrics|Gynecology    Topic: ICD10CM Coding   

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