Coding

Practice e-Tips on Coding - 02/26/2021

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.

Low-Level Code May Have High Misuse - 02/26/2021

It’s been called the “nurse visit” code, and also “the most abused code in the CPT book.” Do you use 99211 correctly?

List Cost on Medicare Radiopharma Claims - 02/05/2021

When billing Medicare for radiopharmaceutical procedure codes, you must list the total acquisition cost on the claim.

Timing for Annual Medicare Mammograms - 11/20/2020

Medicare counts 11 full months after the month in which the patient received her screening

AMA Creates CPT Codes for Combination COVID-19/Flu Tests - 10/15/2020

The American Medical Association (AMA) has created two new Current Procedural Terminology (CPT) codes for multi-virus testing to detect COVID-19 and influenza.

How Health Plans Are Covering COVID-19 Testing and Treatment - 10/09/2020

Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.

Coding Changes Affect UnitedHealthcare Prior Authorization Lists - 09/23/2020

UnitedHealthcare (UHC) has replaced and added procedure codes on its notification and prior authorization (PA) lists.

Code Carefully for Bilateral Procedures - 09/23/2020

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.

Aim for Accuracy in Claims - 09/22/2020

Did you make one of the nearly 1.7 million annual requests to correct minor errors or omissions on a Medicare claim? Novitas Solutions has a new initiative to help you avoid the time and hassle of making corrections.

New Code Accounts for Certain Additional Expenses During Public Health Emergencies - 09/10/2020

The American Medical Association has released a Current Procedural Terminology (CPT) code for reporting additional practice expenses incurred during a public health emergency, including the COVID-19 pandemic.

E&M Coding Changes Among Major CPT Revisions for 2021 - 09/08/2020

The American Medical Association last week released its 2021 Current Procedural Terminology (CPT) code set, which includes major revisions to office and other outpatient evaluation and management (E&M) services designed to decrease physician documentation requirements.

Live Webinar to Help You Prepare for 2021 E&M Coding Changes - 09/01/2020

If you want to learn more about evaluation and management (E&M) coding changes that go into effect Jan. 1, tune in to a live Texas Medical Association webinar: 2021 E/M: Ready Set Go!

The X{EPSU} Modifiers Further Define Modifier 59 - 08/13/2020

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines

E&M Coding About to Change - 08/03/2020

First, the bad news: Physicians need to take some serious time between now and Jan 1, 2021, to study changes that are coming to Medicare outpatient evaluation and management (E&M) codes – changes most private insurers likely will follow. Now the good news: The changes should reduce the amount of documentation needed with each patient.

Take Our Billing and Coding Quiz - 07/17/2020

TMA Knowledge Center staff fields hundreds of questions about coding and billing from TMA members. Here are a few FAQs. Do you know the answers to these questions?

New CPT Code Is “Industry Standard” for COVID-19 Antigen Testing - 07/08/2020

Three new Current Procedural Terminology (CPT) codes are now on the list of COVID-19 lab testing codes, effective June 25

Use “Time, MDM” for Medicare Telehealth Coding - 06/02/2020

When coding for Medicare telehealth visits, you can use either medical decisionmaking (MDM) or time as the basis for your selection of office/outpatient evaluation and management (E&M) levels of service, the Centers for Medicare & Medicaid Services has clarified.

AMA Creates CPT Code for Coronavirus Test - 03/17/2020

The American Medical Association has created a Current Procedural Terminology (CPT) code, 87635, to report laboratory testing services that diagnose the presence of the novel coronavirus.

Examine the Billing Cycle “Vitals” for Your Practice - 11/13/2019

The Texas Medical Association’s free webinar, What You Need to Know to Evaluate Your Billing Process, offers a step-by-step process and tools to assess your practice’s financial health and identify key areas for improvement. The webinar will show you how to use practice management reports to evaluate your staff’s productivity, your billing and collections processes, and even payer performance.

Using Unlisted Codes for Workers' Comp Services - 10/29/2019

Using Unlisted Codes for Workers' Comp Services

Payers Axe Consultation Codes - 08/07/2019

Both Cigna and UnitedHealthcare (UHC) have announced that starting in October, they will no longer pay for CPT consultation codes 99241-99245 – office consultations – and 99251-99255 – inpatient consultations. UHC’s policy change becomes effective Oct. 1, as outlined in its March bulletin. Cigna’s July newsletter says Cigna’s policy takes effect Oct. 19.

Get Dates of Service Right on Medicare Claims - 05/30/2019

When you a perform a Medicare service that is global, has both a professional and a technical component, or spans days or months, you need to know what date Medicare considers to be the official date of service when you file your claim. Here is some guidance from the Centers for Medicare & Medicaid Services (CMS) about coding and billing dates of service on professional claims.

Use Modifiers to Override Correct Coding Initiative Edits - 05/28/2019

Correct Coding Initiative Edits Now Free on Internet

Medicare Critical Care and Initial Hospital Services E and M Slated for Review - 05/17/2019

If you’ve been “probed and educated” twice by Novitas Solutions Inc. for high rate of claims errors regarding certain evaluation and management (E&M) services, you may receive more such review and education this summer.

Use New G Codes for Medicare Therapy Claims - 03/04/2019

Starting with services dated Jan. 1, 2013, physicians have to report new, nonpayable G codes and related modifiers on Medicare claims for outpatient physical, speech, and occupational therapy.