Coding

AMA Creates CPT Code for Coronavirus Test

 

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.

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COVID-19 Coding Resources

AMA Creates CPT Code for Coronavirus Test

Charts Point You in the Right Direction When Coding for Telemedicine

Use “Time, MDM” for Medicare Telehealth Coding

MGMA Coding Cheat Sheet (MGMA)

ICD-10-CM Official Coding and Reporting Guidelines on COVID-19 April 1, 2020 - September 30, 2020 (CDC)

ICD-10-CM Official Coding Guidelines - Supplement Coding encounters related to COVID-19 Coronavirus Outbreak (CDC, Feb. 20, 2020)

Coding encounters related to COVID-19 Coronavirus Outbreak (CDC, Feb. 20, 2020)

New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), October 1, 2020 (CDC, Feb. 20, 2020)

Coding During the Coronavirus Pandemic (Physicians Practice, March 18, 2020)

AMA Coding Advice During COVID-19 (AMA, March 26, 2020)

AAP: Coding for Telemedicine Services (AAP, Jan. 2020)

ACP: COVID-19 Telehealth Coding and Billing Practice Management Tips (ACP, March 30, 2020)

Go to the COVID-19 Resource Center

Payer Policies for Telemedicine Services

 

In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).

Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide.  Stay tuned for more detail.

Updated June 3, 2020

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Coding Myths May Place Physicians at Risk 

 

Do you fully understand the coding and documentation guidelines? Nationwide studies suggest the answer to this question may be “no.” Common coding myths may be a contributing factor to revenue loss and risk of a formal audit in your practice.

Learn About Common Myths  

Tools

Utilize the tools below to assist with your coding questions.

Evaluation and Management (E/M) Services Documentation Guidelines - CMS

Medicare Fee Schedules

Sample Letter: Appeal Letter for Services Incorrectly Denied  

Sample Letter: Getting to Know a Carrier's Surgical Billing Principles  

Important Resources

Use these links to get to more coding resources.

• AMA CPT®: Current Procedural Terminology

  Centers for Medicaid & Medicare Services

  TMA Knowledge Center

  Novitas ­- provides services to Medicare beneficiaries and health care professional

What You Need to Know About Coding

Learn some coding basics as well as more specific information about correct coding in these articles by TMA.

• Back to Basics — Documentation 101 and Self-Auditing 

• Your Billing and Coding Checklist for 2018
• “Incident to” and the Initial Medicare Visit
• Modifiers 22, 52, and 53 for Medicare Claims
• Unraveling Modifier 25
• Low-Level Code May Have High Misuse

Read More Coding Articles 

Consulting for Your Practice

Do you need assistance with coding and documentation procedures in your office? Look over the options TMA has available to physicians. 

• Coding and Documentation Review: A comprehensive analysis of a physician’s coding and documentation techniques presented in a written report with specific findings and opportunities for improvement. 

  Coding and Documentation Check-ups: An abbreviated review of claims coding and medical record documentation performed by a professional coder and auditor to provide a glimpse into a physician’s coding techniques. 

  Coding and Documentation Training: On-site training for physicians and staff on the coding and documentation guidelines, customized to the practice’s specialty.

  TMA 30-Minute Billing Cure: Having problems with coding, billing, reimbursement, denial of services, or filing of claims? Contact your county medical society to schedule a mini-consultation. Free to TMA members.

Learn More About Our Consulting Services 

Vendor Spotlight 

 

InHealth Professional Services offers a full range of publications from nationally-recognized experts in the fields of physician practice management, medical coding & medical education.

About InHealth Professional Services  

ICD-10

The transition to the new ICD-10 coding system took effect on Oct. 1, 2015. Do you need some guidance? TMA has you covered with a variety of tools and resources to get you up to speed.

Go to the ICD-10 Resource Center