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Sometimes payer guidelines differ from the official guidelines, this can be confusing, let’s look at a sequencing priority for example in Chapter 15: Pregnancy, childbirth, and the Puerperium (o00-o9A). the guidelines tell us how to code based on the provider's documentation, in addition, it is important to know Chapter 15 codes are never to be used on newborn records, only on the maternal record. Find-A-Code will sequence codes according to the ICD-10-CM guidelines first.

What happens once the COVID-19 emergency declarations have ended?

Many healthcare providers have chosen to keep medical coding and billing in-house. From HIPAA compliance to the complexity of ICD-10 codes, it has just been easier to keep track of things by not outsourcing medical billing or coding. But things are changing. So much so that 2023 could be the year that outsourced services finally take over.

The Evaluation and Management (E/M) changes made in 2021 and again in 2023 brought about new CPT codes and guidelines for reporting prolonged services. Just as Medicare disagreed with CPT in the manner in which prolonged service times should be calculated, they did so again with the new 2023 changes. Here are three things you should know when reporting prolonged services for all E/M services.

Common sense seems to dictate that medical billing codes, like CPT codes for example, are only considered after medical treatment has been provided. After all, the codes are simply a representation of diagnosed conditions and treatment services provided – for billing purposes. But there is a curious relationship between these codes and actual treatments.

Medical coders play a critical role in determining how healthcare delivery is reported for record keeping and billing purposes. Likewise, the codes they know so well are equally critical. They have been around for decades. They were originally developed and implemented to make reporting and billing easier in a healthcare system that was becoming incredibly more complex. The system is even more complex today.

You are excited about beginning your training as a professional medical coder. You're expecting to pass the exam and earn your certification. The future is looking bright until, as you are perusing the educational material, you suddenly realize you're going to have to learn medical terminology.