SuperCoder Blog

The clinical setting may not be the best place to get an accurate blood pressure reading, and two new CPT^® 2020 codes are here to help. Medical codes 99473 and 99474 apply to self-measured blood pressure services. Here’s what you need to know.

1. Review the Codes and Descriptors

Getting to know any new codes starts with a careful review of their descriptors. The two new codes represent different services:

• Training/calibration: 99473 (Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration)
• Data collection/report: 99474 (… separate self-measurements …
  

Medicare has posted the 2020 National Correct Coding Initiative (NCCI) manual, with the updates helpfully marked in red, as usual. Here are some hints on what you’ll find in the latest version.

Review Radiology Section’s SPECT/Planar and Oncology Updates

First up are changes in the radiology services section of the NCCI manual, which you’ll find in Chapter 9.

SPECT/planar combo codes: Subsection E covers nuclear medicine and includes an update about proper coding when there are both SPECT and planar studies. In short, if there’s a single code that covers …

January 1 is bringing roughly 400 CPT^® code changes. See if you’re ready with this quick medical coding quiz, including links to previous SuperCoder blog posts where you can find the answers.

Start Here With the Questions for 2020 Code Changes

Question 1: CPT^® 2020 is introducing new online digital evaluation and management (E/M) codes for established patients. Which code will apply to 11-20 minutes of cumulative time over seven days?

A. 99421

B. 99422

C. 99423

D. 99444

Question 2: In 2020, <...

If denial prevention is one of your New Year’s resolutions, we’ve got some ideas to help you achieve your goal. Make 2020 your best year yet by watching the little details that matter for your medical claims, including changes for Appropriate Use Criteria, Medicare Beneficiary Identifiers, and global billing address requirements.

1. Remember That Code Updates Affect Policies

One of the most important actions you can take to help your claims is to ensure your medical codes are up to date. The 2020 ICD-10-CM code set was effective for dates of service on and after Oct. 1, 2019. The 2020 CPT^® and HCPCS …

The 2020 Medicare Physician Fee Schedule (MPFS) final rule states Medicare will apply the special rule for multiple endoscopic procedures to nasal/sinus endoscopy medical codes 31231-31298. In case you don’t have time to wade through the whole long rule, here are the major pointers on this change for otolaryngology coders. The change will be effective Jan. 1, 2020, for Medicare claims.

Learn Multiple-Scope Base and Family Codes

The 2020 MPFS final rule makes diagnostic code 31231 (Nasal endoscopy, diagnostic, unilateral or bilateral (…

If you report HCPCS Level II C codes for drugs, there are a handful of changes coming Jan. 1, 2020, that you’ll want to know. Here’s what’s being added and deleted for lefamulin, brexanolone, levoleucovorin, and iodine I-131 iobenguane.

Reminder: HCPCS Level II C codes, meaning codes that start with the letter C, were originally developed by Medicare for use by Outpatient Prospective Payment System (OPPS) hospitals. A short list of non-OPPS hospitals may also use C codes. But physician and other pro-fee claims should not use these codes. Instead, pro-fee claims …

Category III CPT^® codes are separate from the more commonly used Category I codes, making it all too easy to overlook these important codes. Follow the five tips below to help ensure your coding is accurate for Category III codes.

1. Update Cat. III Codes Twice a Year

Consider this question: When are CPT^® codes updated? January 1 is the answer a lot of medical coders automatically reply with. But the CPT^® update calendar is not that simple, and Category III is one of the complications.

The American Medical Association (AMA) implements new CPT^® Category III codes July 1 and January 1. Category III codes are temporary codes …

“Other” tissue graft code 20926 turned into a sort of catch-all code over the years, but that will change with the CPT^® 2020 code set. On Jan. 1, 2020, you’ll have five new medical codes to use in place of 20926. Be ready with these helpful pointers.

Look at 15769-15774 Instead of 20926

In the CPT^® 2019 code set, you look in the musculoskeletal system codes for 20926 (Tissue grafts, other (eg, paratenon, fat, dermis)). In 2020, 20926 will be deleted, and you will move your search for the replacement codes to the integumentary system section.

Other Soft Tissue

• 15769 (Grafting of autologous …