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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2020 Medicare Part D Coverage Gap (AKA donut hole)


Not every Medicare drug plan has complete coverage for prescription drugs - most have some sort of coverage gap, known as the “Donut Hole”. The coverage gap is a temporary limit on coverage under the drug plan. This coverage gap will not affect everyone and begins after you have used ...

tags  Payer: CMS|Medicare    Topic: Pharmaceutical   

Acupuncture Clarification


In the ChiroCode Newsletter released yesterday regarding Medicare coverage of acupuncture, one sentence in particular has let to some confusion. Read more about it here.

tags  Specl: Chiropractic    Topic: Procedure Coding   

New HCPCS Code for Coronavirus Testing Announced


Currently, healthcare providers testing patients for Coronavirus must use an unspecified code. To provide better tracking, on February 13, 2020, CMS announced the creation of a new HCPCS code.

tags  Specl: All Specialties    Topic: Code Updates    Topic: ICD10CM Coding   

Medicare Begins Covering Acupuncture Services


Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

tags  Specl: Chiropractic    Topic: Procedure Coding   

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


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?

tags  Specl: Chiropractic    Topic: Claims Processing    Topic: Diagnosis Coding    Topic: ICD10CM Coding   

Documentation Skills that Increase Your Coding


Evidence-based medicine such as the updated periodontal staging and caries lesions also gives well-defined information about the clinical condition itself. You cannot just look at the codes, you need to check the policy. When I am coding or teaching coding, you need to use clinical indications when working with documentation ...

tags  Specl: Dental   

New Biofeedback Codes to replace 90911 Eff 2020-01-01


CMS announced 90912 and 90913 are to be used starting January 2020 in place of 90911. According to CMS MLN, these new codes, designated as “sometimes therapy”, are reported to furnish these services outside a therapy plan of care when appropriate. Codes are permitted to be used by physicians and Non-Physician Practitioners (NPPs), ...

tags  Specl: Acupuncture|Alternative    Specl: Physical Medicine|Physical Therapy    Topic: CPT Coding   

A 2020 Radiology Coding Change You Need To Know


The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...

tags  Loc: All Locations    Payer: All Payers    Specl: Billing    Specl: Cardiology|Vascular    Specl: Emergency Medicine    Specl: Gastroenterology    Specl: General Surgery    Specl: Interventional Radiology    Specl: Neurology|Neurosurgery    Specl: Orthopedics    Specl: Radiology    Specl: Rheumatology    Specl: Urology|Nephrology    Topic: Auditing    Topic: Coding    Topic: CPT Coding    Topic: Procedure Coding   

Documenting telephone calls at your dental practice is just as important as documenting patient visits.


Documenting telephone calls at your dental practice is just as important as documenting patient visits. Similar to other documentation, the common rule when it comes to call documentation is that if it is not documented, it did not happen. Therefore, every clinically relevant telephone call should be documented. Clinically relevant calls ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

Medicare Announces Coverage of Acupuncture Services


On January 21, 2020, a CMS Newsroom press-release read, This new announcement is both exciting and refreshing. Acupuncture, a key component of traditional Chinese medicine and most commonly used to treat pain, is now being officially recognized by Medicare and several other large payers as a covered, alternative treatment option for ...

tags  Loc: All Locations    Payer: All Payers    Payer: CMS|Medicare    Specl: Acupuncture|Alternative    Specl: Orthopedics    Specl: Pain Management    Topic: Coding    Topic: CPT Coding    Topic: Documentation    Topic: ICD10CM Coding    Topic: ICD9v3 Coding    Topic: Medicare   

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