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Latest articles

2020 Medicare Part D Coverage Gap (AKA donut hole)
March 26th, 2020 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
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 ...
LATEST COVID-19 INFORMATION FOR BILLING NON-FACE-TO-FACE SERVICES
March 26th, 2020 - Namas
Healthcare providers and the population at large are concerned about safe access to care considering the COVID-19 pandemic. As a result, we have received many inquiries this week about how to bill for “telehealth” services. Let’s first address that true telehealth services have some pretty stringent requirements from CMS, including that ...
COVID-19: Cybercrime, Telehealth, and Coding
March 25th, 2020 - Wyn Staheli, Director of Research
Your inbox is probably like mine with all sorts of announcements about COVID-19. Here are just a few reminders of things we felt should be passed along. We have heard of several cases of cybercrime related to this outbreak. For example, there was a coronavirus map which loads malware onto your ...
Understand the New Codes for Testing & Reporting the COVID-19 Coronavirus (SARS-CoV-2)
March 21st, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
The current coronavirus pandemic refers to COVID-19, a novel or new type of coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first victim of the virus was identified in Wuhan, Hubei, China at the end of 2019. There is no immunization available to prevent it from spreading and ...
Implementing Telehealth Visits
March 20th, 2020 - Namas
The following is a step-by-step guide on how to convert office-based encounters to telehealth encounters during the current COVID-19 pandemic. These rules may change post-pandemic, as many changes relaxing existing rules were made on a temporary basis by CMS and commercial payers to facilitate patient access and minimize risk of infection. Step ...

Editors choice articles

Understand the New Codes for Testing & Reporting the COVID-19 Coronavirus (SARS-CoV-2)
March 21st, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
The current coronavirus pandemic refers to COVID-19, a novel or new type of coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first victim of the virus was identified in Wuhan, Hubei, China at the end of 2019. There is no immunization available to prevent it from spreading and ...
Implementing Telehealth Visits
March 20th, 2020 - Namas
The following is a step-by-step guide on how to convert office-based encounters to telehealth encounters during the current COVID-19 pandemic. These rules may change post-pandemic, as many changes relaxing existing rules were made on a temporary basis by CMS and commercial payers to facilitate patient access and minimize risk of infection. Step ...
Additional Coronavirus Testing Code Announced
March 17th, 2020 - Wyn Staheli, Director of Research
On March 13, 2020, a new CPT code was announced by the American Medical Association (AMA) who maintains the CPT code set. This early release of a CPT code is rare and is effective immediately.
New HCPCS Code for Coronavirus Testing Announced
February 20th, 2020 - Wyn Staheli, Director of Research
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.
A 2020 Radiology Coding Change You Need To Know
February 10th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
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...

Latest questions/posts

Fracture treatment and xrays
   Mar 26th, 2020 - rdinaso    12  1 

Billing with an "add on" code
1st    Mar 19th, 2020 - pattioconnor

Hospital Discharge Code 99239
   Mar 13th, 2020 - abbyakinleye 9 

LV Septal Pacing
   Feb 7th, 2020 - sharris

Medicare denying claims, reason CO-45
   Jan 29th, 2020 - phil.jen

CPT 99213 w/ 98941, 97110 or 97140 for Aetna
1st    Jan 22nd, 2020 - phil.jen

Billing patients/attorney with no insurance
1st    Jan 21st, 2020 - bells221

coding question
   Jan 13th, 2020 - nate0922 7 

Cpt codes 99473 and 99474
   Jan 2nd, 2020 - Krogers

Medicare denied the claim
   Dec 13th, 2019 - NAHAR, SHAMSU

CPT code for Interosseous Bioplasty
   Dec 12th, 2019 - rdinaso    12  1 

medicaid primary claim denied due to timely fling
   Dec 12th, 2019 - NAHAR, SHAMSU

codes 27310
1st    Dec 10th, 2019 - maryN.

Gastroenterology question on codes
   Dec 9th, 2019 - trixiecane

Gastroenterology question on codes
1st    Dec 9th, 2019 - trixiecane

J1071 Code
1st    Nov 15th, 2019 - Alicia

Code for Escharotic treatment?
1st    Nov 12th, 2019 - Amanda_Marie

CPT 96405
   Nov 12th, 2019 - npott1 9 

Extirpation of matter from the Pulmonary Artery
   Nov 1st, 2019 - stomach1 3 

Blue cross Blue shield denies office visits/E& M visits.
   Oct 15th, 2019 - gowri.tina


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