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Coding Ahead

The Codepedia for Medical Coding

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Coding Ahead

The Codepedia for Medical Coding
  • CPT
  • News & Updates
  • Coding FAQ’s
  • Coverage For Chiropractic Services
  • Reimbursement
  • ICD
  • Modifiers
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    • Clinical Examples
    • CPC Sample Questions

Clinical Examples

  • by Coding Ahead
  • Clinical Examples, Learning

The clinical examples that are provided here are limited to Office or Other Outpatient Services, Hospital Inpatient Services, Consultation, Emergency and Critical Care services. These… Read More »Clinical Examples

Answers for CPC sample Questions

  • by Coding Ahead
  • CPC Sample Questions, Learning

CPC sample question # 1 CPT 26123, 26125, ICD-9-CM 728.6 26123 is used for reporting the Fasciectomy, with release of 1 single digit and 26125… Read More »Answers for CPC sample Questions

List Of All Modifiers

  • by Coding Ahead
  • CPT, CPT Categories

Modifier – as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbursement. Modifiers may… Read More »List Of All Modifiers

North Carolina Medicaid – Billing Guidelines for Vaccines

  • by Coding Ahead
  • Coding Guidelines For Vaccines, CPT, CPT Updates, Medicaid Reimbursement, Other Topics, Reimbursement

1. Effective with date of service July 1, 2011, the ONLY immunization administration codes covered for Medicaid recipients in the Health Check age range, 0 through… Read More »North Carolina Medicaid – Billing Guidelines for Vaccines

Medicare Uncompensated Care Payments

  • by Coding Ahead
  • Covid-19, Other Topics

CMS distributes a prospectively determined amount of uncompensated care payments to “Medicare disproportionate share hospitals” based on their relative share of uncompensated care nationally.  As… Read More »Medicare Uncompensated Care Payments

COVID-19 Frequently Asked Questions (FAQs) – Released May 5, 2020

  • by Coding Ahead
  • Covid-19, Other Topics, Telehealth, Telemedicine

CMS Releases Additional Medicaid & CHIP COVID-19 FAQs for State Medicaid and CHIP Agencies CMS released additional frequently asked questions (FAQs) to aid state Medicaid… Read More »COVID-19 Frequently Asked Questions (FAQs) – Released May 5, 2020

Revised Guidelines for CPT 99441, 99442 & 99443

  • by Coding Ahead
  • Covid-19, Other Topics, Telehealth, Telemedicine

Updated May 9, 2020, with information from the 4/30/20 rule CMS will pay for phone calls using codes 99441—99443. The 4/30/20 rule adds these to… Read More »Revised Guidelines for CPT 99441, 99442 & 99443

MAC will Reprocess the claims – Telephone E&M; Visits

  • by Coding Ahead
  • Covid-19, Other Topics, Telehealth, Telemedicine

The March 30 Interim Final Rule with Comment Period added coverage during the Public Health Emergency for audio-only telephone evaluation and management visits (CPT codes… Read More »MAC will Reprocess the claims – Telephone E&M; Visits

CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes

  • by Coding Ahead
  • Other Topics, Telehealth, Telemedicine

As a part of President Trump’s Opening Up America Again effort, the Centers for Medicare & Medicaid Services (CMS) announced a new independent Commission that… Read More »CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes

Evaluation and Management (E/M) Effective January 1, 2021

  • by Coding Ahead
  • Evaluation and Management Services, Other Topics

New Patient: (99201 has been deleted. To report, use 99202) 99202 Office or other outpatient visit for the evaluation and management of a new patient,which… Read More »Evaluation and Management (E/M) Effective January 1, 2021

Annual Updates for Flu Vaccine_2019-2020 – Season (Payment Allowance)

  • by Coding Ahead
  • News & Updates

This recurring update notification provides the availability of payment allowances for the seasonal influenza virus vaccines as updated on an annual basis, effective August 1… Read More »Annual Updates for Flu Vaccine_2019-2020 – Season (Payment Allowance)

New HCPCS Modifiers Effective from Jan 1, 2020

  • by Coding Ahead
  • Modifier Updates, Modifiers

HCPCS Modifiers: MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected… Read More »New HCPCS Modifiers Effective from Jan 1, 2020

UHC – Reimbursement Update to Vaccines for CPT 90461

  • by Coding Ahead
  • News & Updates

As part of the Patient Protection and Affordable Care Act (PPACA) regulations, CPT code 90461 is not reimbursable for vaccines administered to Medicaid members through… Read More »UHC – Reimbursement Update to Vaccines for CPT 90461

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Categories

Recent Posts

  • North Carolina Medicaid – Billing Guidelines for Vaccines
  • Medicare Uncompensated Care Payments
  • COVID-19 Frequently Asked Questions (FAQs) – Released May 5, 2020
  • Revised Guidelines for CPT 99441, 99442 & 99443
  • MAC will Reprocess the claims – Telephone E&M; Visits
  • CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes
  • Evaluation and Management (E/M) Effective January 1, 2021
  • Annual Updates for Flu Vaccine_2019-2020 – Season (Payment Allowance)
  • New HCPCS Modifiers Effective from Jan 1, 2020
  • UHC – Reimbursement Update to Vaccines for CPT 90461
  • Horizon BCBSNJ Reimbursement Guidelines Changes in Outpatient Laboratory Claims
  • Changes in Reimbursement Guidelines for Behavioral Health services
  • Revised NCD list Effective from January’2020
  • Screening and Diagnostic Mammography — Retired Part A and Part B LCD
  • 2020 ICD-10 CM New Codes Effective from October 1, 2019
  • Stop Hepatitis B via HBsAg Screening in Pregnant Women
  • United Healthcare Commercial Reimbursement Policy Updates effective from Sep 1st, 2019
  • Allergy Test CPT Codes Limitation for Florida Blue
  • HCPCS Codes Changes effective from October 1, 2019
  • Upcoming CPT (NEW) Code Changes Effective from October 1, 2019

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