The leaves are beginning to change and it’s time once again for the annual code changes for 2019. ICD-10-CM codes are out and will be effective October 1, 2018. CPT code changes also just came out and will be effective January 1, 2019. The ChiroCode DeskBook and ICD-10-CM Coding for Chiropractic books have been updated and are now shipping! HCPCS code changes are not yet available, but will be by December, at which time, we will let you know about revisions that may affect your practice.
As for ICD-10-CM codes, the one that is most significant for chiropractic care is the expansion of the code we typically use for myofascial pain syndrome, M79.1 “Myalgia”. It has been expanded to the following:
M79.10 Myalgia, unspecified site M79.11 Myalgia of mastication muscle M79.12 Myalgia of auxiliary muscles, head and neck M79.18 Myalgia, other site
Be sure to implement policies to ensure documentation clearly identifies the site to ensure proper code selection.
Code G71.0 “Muscular dystrophy” has also been expanded and there are hundreds of other less significant changes. There were quite a few minor revisions to the External Causes, Chapter 20. For example, snowboarding is now one word instead of two.
The CPT codebook also has hundreds of changes and although there are no changes to the bread-and-butter CMT codes, code 64550 “ Application of surface (transcutaneous) neurostimulator (eg, TENS unit)” has been deleted. It appears that the surface application of neurostimulators is no longer separately payable.
Other ChiroCode DeskBook Updates
Code changes aren't the only thing changed in the 2019 ChiroCode DeskBook. We also have:
New x-ray coding table makes code selection easier
Revised Timed Codes segment to clarify multiple procedure reporting requirements
Added more index terms
Medicare section updated. Includes Qualified Medicare Beneficiary (QMB) Program information New appendix discusses the details of Medicare’s proposed E/M guideline revisions.
To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number.
Take a look at the following
J1071 - Injection, testosterone cypionate, 1mg
For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL
(100 mg/mL = 1 mL and there are ...
As we begin returning back to work, we will all face a new normal. The COVID-19 pandemic has changed the face of business. While it has certainly been a challenge to keep up with the ever-changing regulations (that’s likely to continue for a little longer), exciting new opportunities have also been created, such as the expansion of telemedicine. There’s also the maze of government funding that needs to be navigated and an increased awareness of OSHA standards to implement.
The CDC has released additional information and coding guidance for reporting encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI).
The update offers coding scenarios for general guidance, poisoning and toxicity, substance abuse and signs and symptoms.
ICD-10-CM Official Coding Guidelines - ...
On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.
Risk adjustment is simply a way of making sure that there are sufficient funds to adequately take care of the healthcare needs of a certain population. It’s a predictive modeling methodology based on the diagnoses of the individuals in that population. As payers move to value based models, they heavily rely on risk adjustment to ensure proper funding.
All healthcare providers who are currently participating in the MIPS portion of Medicare’s Quality Payment Program may want to participate in the new COVID-19 Clinical Trials improvement activity. Read more about it here.
With all the new laboratory test codes that have been added due to the current public health emergency (PHE), there are a few additional guidelines CMS has released about collecting samples to perform the testing. Please keep in mind that these guidelines are by CMS and may or may not apply to other commercial payer policies.