Finish Your CPT® 2019 Overview With Lab to E/M: Part 3

Fri, Sep 14, 2018



We’re in the home stretch of our first look at CPT® 2019! Let’s finish strong. Here’s Part 3, the last post in our series on new five-digit Category I CPT® 2019 codes.

Don’t forget: Part 1 covers FNA to cardiovascular surgery, and Part 2 covers lymph node biopsy to breast MRI. This is just a quick overview of expected changes and doesn’t include Cat. III or PLA. You’ll need an official version of the codes and guidelines to use when the code set is effective on Jan. 1, 2019, to be sure you have the most up-to-date version of these …

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New CPT® 2019 Codes From Biopsy to Breast MRI! Part 2

Wed, Sep 12, 2018


CPT® 2019 has so many additions coming, we couldn’t fit them all in one post. Here is the overview of the next bunch so you can start forming your update plans and not miss a beat when you start using the new codes.

Reminders: Part 1 covers FNA to cardiovascular surgery. This series of posts is about new five-digit Category I CPT® 2019 codes effective January 1, 2019. The posts don’t cover Cat. III or PLA code additions. Changes may occur before the code set is effective, so be sure you get a resource with official 2019 codes, descriptors, and guidelines in time for the new …

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Get Your CPT® 2019 Overview of New Codes Here! Part 1

Thu, Sep 6, 2018


Start your AMA CPT® 2019 update prep with this quick primer on what you can expect when the new code set goes into effect Jan. 1, 2019.

Note: This post will look at new Category I codes with 5 digits (not Cat. III or PLA codes). And remember that the information may change before the new code set is effective. Be sure your code for 2019 dates of service using the final official AMA code set. Also, check coverage and payment rules for the new codes that affect you so you know what to expect from payers.

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Provider Change Practice? Understand 2019 Payments for MIPS 2017 Performance Year

Tue, Sep 4, 2018


understand MIPS payment adjustments

With 2018 being in its last half, questions are coming up about MIPS payment adjustments in 2019 based on the 2017 performance year. One topic of interest is what happens if a clinician moved from one practice to another. Here is an answer, straight from the CMS Fact Sheet on 2019 MIPS payment adjustments based on 2017 scores.

Know What Happens When There’s a New TIN

The scenario the Fact Sheet provides is that a doctor (Dr. Delta) received …

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Jumpstart CPT® 2019 Radiology Prep With Editorial Panel Sneak Peek

Mon, Aug 27, 2018


CPT® 2019 radiology codes will be available for review soon, but you can get hints of what’s to come if you know where to look. The CPT® Editorial Panel’s summary documents give a glimpse of what’s been proposed and what’s been accepted, and the ACR has helped narrow the list to those most important to radiology.

Here are a few radiology services to keep on your radar when CPT® 2019 update time rolls around.

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Here’s How ICD-10-CM Official Guidelines Apply to New Ecstasy Poisoning Codes

Thu, Aug 23, 2018



ICD-10-CM 2019 is adding a new subcategory for “poisoning by ecstasy,” effective Oct. 1, 2018. Poisoning is one of those coding terms that has a more complex meaning than you may first suspect. Read on to get clarity on when to use these new codes.

Catch Complete Character Requirements for Ecstasy Codes

ICD-10-CM 2019 adds subcategory T43.64- (Poisoning by ecstasy). Notes with the code tell you that other terms you may see include poisoning by MDMA and poisoning by 3,4-methylenedioxymethamphetamine.

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40650-40654 Myth Buster: Get the Truth Behind 3 Problem Areas for Lip Repair Codes

Mon, Aug 20, 2018


Reimbursement for full-thickness lip-repair codes 40650-40654 ranges from about $300 to $600 on the MPFS, so you want to be sure you use these codes correctly. Watch out for three common myths that can lead to reporting errors for these codes:

  • 40650 (Repair lip, full thickness; vermilion only)
  • 40652 (… up to half vertical height)
  • 40654 (… over one-half vertical height, or complex).

Myth 1: You Can’t Use 40650-40654 for Surgically Created Wounds

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ICD-10-CM 2019: Know the Documentation You’ll Need for New Gallbladder and Cholangitis Codes

Thu, Aug 16, 2018


If you code cholecystitis or cholangitis, you’ll want to know these new codes when ICD-10-CM 2019 kicks in on Oct. 1, 2018. Check out the helpful hints below to be sure you know how to apply the codes from the get-go.

Watch ‘Code First’ Note With New Cholecystitis Codes

ICD-10-CM 2019 adds new subcategory K82.A- (Disorders of gallbladder in diseases classified elsewhere).

There are two complete, reportable codes in the subcategory:

  • K82.A1 (Gangrene of gallbladder in cholecystitis)
  • K82.A2 (Perforation of gallbladder in cholecystitis).
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Modifier 58 or 78? Master These Confusing Modifiers

Mon, Aug 13, 2018


choosing between modifier 58 and modifier 78 for procedures

Knowing when to use modifiers 58 and 78 isn’t easy. Base your choices on this straight-from-Medicare guidance to help ensure cleaner claims.

Make Modifier 58 Your Choice for Anticipated Procedures

Modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is the focus of Medicare Claims Processing Manual (MCPM), chapter 12, section 40.2.A.6.

Here are the reasons that the MCPM gives for why a physician may use …

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Crash Course: Compare ICD-10-CM 2019 Official Guidelines for Post-Op Sepsis to 2018 Rules

Thu, Aug 9, 2018


The ICD-10-CM 2019 Official Guidelines are out and offer more details on how to use new codes for sepsis following a procedure. Take a look at what’s new and get a handle on how to sequence these codes.

Remember These New Codes to Improve Sepsis Coding

ICD-10-CM 2019 includes these two new codes with instructional notes:

  • Obstetrical: O86.04 (Sepsis following an obstetrical procedure)
    • Use additional code to identify the sepsis
  • Other procedures: T81.44X- (Sepsis following a procedure)
    • Use additional code to identify the sepsis.
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