State Specific Medical Coding Resources
articles, webinars, links, files and other resources for state specific coding, reimbursement and compliance
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recent articles
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October 14th, 2021
Five Major ICD-10-CM Changes That Can Effect Your Organization
| Published October 14th, 2021
Have you had a chance to review the new ICD-10-CM codes for FY 2022? Did you know that many payers do not want to see unspecified codes when there is a possibility for better data? How adept are you at assigning and sequencing COVID-19 codes? Take a minute to review 5 of the major changes to the FY2022 ICD-10-CM code updates and claim your chance to watch our most recent webinar where we review the newest code updates.
October 13th, 2021
New Codes for Pediatric COVID Vaccinations
| Published October 13th, 2021
On October 6, 2021, the AMA released three new codes to track COVID-19 vaccinations in the pediatric population.
October 12th, 2021
Staging and Grading Periodontitis
| Published October 12th, 2021
We now understand periodontitis may present itself as a manifestation of systemic diseases in fact; according to DeltaDental, research shows that more than 90 percent of all systemic diseases have oral manifestations, including swollen gums, mouth ulcers, dry mouth, and excessive gum problems. Some of these diseases include:
Diabetes
Leukemia
Oral cancer
Pancreatic cancer
Heart ...
October 6th, 2021
Summary of 2019 Changes to the ADA Dental Form
| Published October 6th, 2021
In 2019 the ADA revised the ADA Dental claim form to incorporate editorial changes to further its consistency with the 837D. The previous update was in 2012, the changes in 2012 were made to incorporate the capability to report diagnoses codes.
Some of the important changes include Bx# 8 and 15, the description was updated ...
October 6th, 2021
Dental-Provider Specialty Taxonomy Codes
| Published October 6th, 2021
The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general ...
October 6th, 2021
ICD-10-CM Cracks Down on the Use of "Unspecified" in the 2021 Official Guidelines
| Published October 6th, 2021
We always knew there would come a day when payers would look down on an "unspecified" diagnosis code and possibly even deny it or delay payment until a review of the record could be performed. ICD-10-CM was adopted by the U.S. for data analytics, which cannot be accurate if unspecified codes are reported when the documentation verifies greater specificity. Join us for a look at the many guideline changes to ICD-10-CM, a review of the newest code changes and suggestions on documentation improvement to elevate coding protocols.
October 4th, 2021
Watch out for New ICD-10-CM Codes
| Published October 4th, 2021
New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.
September 30th, 2021
How Well Will Your Organization Score in the 2022 Star Rating Measures?
| Published September 30th, 2021
How ready is your organization for implementation of the 2022 new Star Rating measures? Creating opportunities for staff to share innovative ideas is essential to creating a successful outcome, so take a minute to review the Part C and D measures today.
September 30th, 2021
Is Coding Based on Addendums or Late Entries Putting You At Risk of Audit Failure?
| Published September 30th, 2021
Independent Health, another Medicare Advantage Organization, has been named in a qui tam (whistleblower) lawsuit and enjoined by the DOJ for allegations of fraudulently upcoding to increase beneficiary risk adjustment scores to obtain higher reimbursement. It appears they used DxID, LLC, a coding consulting subsidiary of Independent Health to retrospectively identify and have providers addend unsupported diagnoses. How is your organization actively protecting against accusations of upcoding by improper use and reporting of diagnoses from provider addenda?
September 29th, 2021
Injection Services
| Published September 29th, 2021
Injection Service Codes
Injection service codes, are reported under administration of vaccines/toxoids, using 96372, 90460, 90461, 90471, 90472, 0001A, 0002A, 0003A, 0011A, 0012A, 0021A, 0022A, 0031A, 0041A, and 0042A.
Other injections services include:
Non-antineoplastic hormonal therapy injections – 96372
Anti-neoplastic nonhormonal injection therapy 96401
Anti-neoplastic hormonal injection therapy- 96402
Allergen immunotherapy - 95115-95117
According to CMS, do ...
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