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Showing posts from July, 2021

ICD 10 CM Official Updates and Changes - 2022 - New Codes

The   2022 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2022.  These 2022 ICD-10-CM codes are to be used for discharges occurring from October 1, 2021, through September 30, 2022, and for patient encounters occurring from October 1, 2021, through September 30, 2022. Total changes - 243 New Codes  - 191 Additions Deleted Codes - 25 Deletions Revised Codes - 27 Revisions   NEW CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022 Code Description A79.82 Anaplasmosis [A. phagocytophilum] C56.3 Malignant neoplasm of bilateral ovaries C79.63 Secondary malignant neoplasm of bilateral ovaries C84.7A Anaplastic large cell lymphoma, ALK-negative, breast D55.21 Anemia due to pyruvate kinase deficiency D55.29 Anemia due to other disorders of glycolytic enzymes D75.83 Thrombocytosis D75.838 Other thrombocytosis D75.839 Thrombocytosis, unspecified D89.44 Hereditary alpha tryptasemia E75.244 Niemann-Pick disease type A/B F32.A Depression,

Smoking Cessation Counselling

Smoking Cessation The following codes are used to report the preventive medicine evaluation and management of infants, children, adolescents, and adults. Modifier 25 should be added to the office/outpatient code to indicate that a significant, separately identifiable evaluation and management service was provided on the same day as the preventive medicine service. The appropriate preventive medicine service is additionally reported. 99406 – Smoking and tobacco-use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes  99407 – Smoking and tobacco-use cessation counseling visit; intensive, greater than 10 minutes  Required Documentation Patient Current smoking details  Time  Counseling Content  Covered ICD Codes  F17.210 -  Nicotine dependence, cigarettes, uncomplicated F17.211 -  Nicotine dependence, cigarettes, in remission F17.213 -  Nicotine dependence, cigarettes, with withdrawal F17.218 -  Nicotine dependence, cigarettes, with other nicotine-induced diso

COVID-19 updates UnitedHealthcare

Temporary cost-share waivers extended to Oct. 17, 2021 The national public health emergency has been extended from July 19, 2021, to Oct. 17, 2021. Below is an overview of how that extension affects temporary provisions for COVID-19 testing and testing-related visits. Individual Exchange, Individual and Group Market health plans:  From Feb. 4, 2020, through the national public health emergency period, UnitedHealthcare is waiving cost-sharing for in-network and out-of-network COVID-19 tests and testing-related visits. Medicare Advantage:  From Feb. 4, 2020, through the national public health emergency period, UnitedHealthcare is waiving cost-sharing for in-network and out-of-network tests for COVID-19, including testing-related telehealth visits. Medicaid:  State-specific rules and other state regulations may apply. For Medicaid and other state-specific regulations, please refer to your state-specific website or your state’s UnitedHealthcare Community Plan website. 

CMS Unveils Surprise-Billing Rules

Proposed Billing Rules 2022 CMS unveiled July 2 the first in a series of rules aimed at shielding patients from surprise billing. The interim final rule addresses several provisions in the No Surprises Act passed by Congress last year. Most provisions outlined in the proposed rule will not take effect until Jan. 1, 2022.  Ten things to know, 1. Bans surprise billing for emergency services The interim final rule bans surprise billing for emergency services, regardless of where they are provided.  Providers are required to bill emergency services on an in-network basis without prior authorization. 2. Bans high out-of-network cost-sharing for emergency and non-emergency services  CMS proposed that patient cost-sharing, including coinsurance and deductibles, be based on in-network provider rates.  This means that cost-sharing can't be higher than if the services were provided by an in-network physician.  3. Bans surprise billing for ancillary services and any "others."  The i

ICD-10 CM Clinical Examples for Documentation

CLINICAL DOCUMENTATION The providers need to be specifying the anatomical location and laterality in the documentation to select the appropriate most specific ICD codes.  There are a few examples of clinical documentation updated below and how the physicians and clinicians communicate and what they pay attention to it is a matter of ensuring the information is captured in your documentation. In ICD-10-CM, there are three main categories of changes, Definition Changes Terminology Differences Increased Specificity The expansion of ICD-10 codes is due to the addition of laterality (left, right, bilateral). Physicians and other clinicians likely already note the side when evaluating the clinically pertinent anatomical site(s). Clinical Examples:1 - ACUTE MYOCARDIAL INFARCTION (AMI) When documenting an AMI, include the following, Timeframe An AMI is now considered “acute” for 4 weeks from the time of the incident. The episode of care ICD-10 does not capture an episode of care (e.g. initial,

Cardiac Device Billing CPT Codes

Cardiac Device Monitoring Services CPT 93294, 93295, 93296 -  Reported no more than once every 90 days. Do not report if the monitoring period is less than 30 days. CPT 93297, 93299, G2066 -  Reported no more than once every 30 days. Do not report if the monitoring period is less than 10 days. CPT 93264 - Reported no more than once every 30 days. Do not report if the monitoring period is less than 30 days. May not be reported with in-person interrogation device evaluations and programming on the same date by the same individual. For subcutaneous cardiac rhythm monitors, may not be reported with programming device evaluations for pacemakers and ICDs. It may be reported with programming device evaluations during the remote interrogation device evaluation period. May not be reported with in-person interrogation and device evaluations on the same date by the same individual.  Report only remote services when an in-person interrogation device evaluation is performed during a period of remot

Glimpses of ICD 10 CM Revised Codes - 2022

Changes Codes Description Revise from: G7120 Congenital myopathy, unspecifed Revise to: G7120 Congenital myopathy, unspecified Revise from: M3500 Sicca syndrome, unspecified Revise to: M3500 Sjogren syndrome, unspecified Revise from: M3501 Sicca   syndrome with keratoconjunctivitis Revise to: M3501 Sjogren syndrome with keratoconjunctivitis Revise from: M3502 Sicca   syndrome with lung involvement Revise to: M3502 Sjogren syndrome with lung involvement Revise from: M3503 Sicca   syndrome with myopathy Revise to: M3503 Sjogren syndrome with myopathy Revise from: M3504 Sicca   syndrome with tubulo-interstitial nephropathy Revise to: M3504 Sjogren syndrome with tubulo-interstitial nephropathy Revise from: M3509 Sicca   syndrome with other organ involvement Revise to: M3509 Sjogren syndrome with other organ involvement Revise from: T63611A Toxic effect of contact with Portugese Man-o-war, accidental (unintentional),

Glimpses of ICD 10 CM Deleted Codes - 2022

Deleted Codes Description D552 Anemia due to disorders of glycolytic enzymes F78           Other intellectual disabilities G92           Toxic encephalopathy K228 Other specified diseases of esophagus M311 Thrombotic microangiopathy M545 Low back pain P09           Abnormal findings on neonatal screening R05           Cough R358 Other polyuria R633 Feeding difficulties T407X1A Poisoning by cannabis (derivatives), accidental (unintentional), initial encounter T407X1D Poisoning by cannabis (derivatives), accidental (unintentional), subsequent encounter T407X1S Poisoning by cannabis (derivatives), accidental (unintentional), sequela T407X2A Poisoning by cannabis (derivatives), intentional self-harm, initial encounter T407X2D Poisoning by cannabis (derivatives), intentional self-harm, subsequent encounter T407X2S      Poisoning by cannabis (derivatives), intentional self-harm, sequela T407X3A Poisoning by cannabis (derivatives), assault, initial encounte

Glimpses of ICD 10 CM Codes - 2022

Just see below for the number of codes that are added, deleted, and revised in 2022 Total numbers of codes in  2021  - 72621 codes Total numbers of codes in  2022  - 72748 codes ICD 10 CM Updates for 2022 Total changes - 211 159 additions 32 deletions 20 revisions Click here to check the list of New ICD 10 CM Codes

Glimpses of ICD 10 CM New Codes - 2022

 ICD 10 CM New Code Description A7982 Anaplasmosis [A. phagocytophilum] C563 Malignant neoplasm of bilateral ovaries C7963 Secondary malignant neoplasm of bilateral ovaries C847A Anaplastic large cell lymphoma, ALK-negative, breast D5521 Anemia due to pyruvate kinase deficiency D5529 Anemia due to other disorders of glycolytic enzymes D75838 Other thrombocytosis D75839 Thrombocytosis, unspecified D8944 Hereditary alpha tryptasemia E75244 Niemann-Pick disease type A/B F32A Depression, unspecified F78A1 SYNGAP1-related intellectual disability F78A9 Other genetic related intellectual disability G0482 Acute flaccid myelitis G4486 Cervicogenic headache G9200 Immune effector cell-associated neurotoxicity syndrome, grade unspecified G9201 Immune effector cell-associated neurotoxicity syndrome, grade 1 G9202 Immune effector cell-associated neurotoxicity syndrome, grade 2 G9203 Immune effector cell-associated neurotoxicity syndrome, grade 3 G9204 Immune