Medical Coding

AMA Announces CPT Code Update for Monkeypox Vaccines, Testing

by Victoria Bailey

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a laboratory test CPT code for the orthopoxvirus and two CPT codes for the monkeypox...

AMA Announces CPT Code for Moderna COVID-19 Vaccine for Young Kids

by Victoria Bailey

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for children aged six months through five...

CA Doctor Sentenced in Medicare Fraud Scheme Involving Upcoding

by Victoria Bailey

A California doctor has been sentenced to prison for nearly eight years after his involvement in a $12 million Medicare fraud scheme in which he upcoded and billed Medicare for unnecessary...

AMA Announces CPT Codes for Potential COVID-19 Boosters

by Victoria Bailey

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for two COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline...

Professional, Hospital E/M Charge Index Continued to Grow in 2021

by Victoria Bailey

The median charge index for hospital evaluation and management (E/M) visits increased by 7 percent during the COVID-19 pandemic, according to a white paper from FAIR Health. The FH Medical Price Index...

Exploring the Fundamentals of Medical Billing and Coding

by Editorial Staff

Medical billing and coding translate a patient encounter into the languages healthcare facilities use for claims submission and reimbursement. Billing and coding are separate processes, but both are necessary for providers to receive...

AMA Updates CPT Codes for Pediatric COVID-19 Vaccine

by Sarai Rodriguez

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a new code for administering pediatric doses of Pfizer’s COVID-19 vaccine...

CPT Code for Third Dose of Pediatric COVID-19 Vaccine Added

by Jacqueline LaPointe

The American Medical Association (AMA) announced a Current Procedural Terminology (CPT) code set update to include a code for administering a third dose of Pfizer’s COVID-19 vaccine in...

CPT Code Set Adds Code for J&J COVID-19 Vaccine Booster

by Jacqueline LaPointe

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a new code for COVID-19 vaccine booster doses of the vaccine created by Janssen...

How E/M Coding Changes Became an Urgent Problem for a TN Clinic

by Jacqueline LaPointe

The past year has been tough for AFC Urgent Care Memphis, Tennessee. Like most practices, the small urgent care clinic saw patient volume dip dramatically at the start of the COVID-19 pandemic. And like their peers, this all happened...

AMA Issues CPT Codes for Pediatric Doses of Pfizer COVID-19 Vaccine

by Victoria Bailey

The American Medical Association (AMA) has issued new Current Procedural Terminology (CPT) codes for pediatric doses of the Pfizer COVID-19 vaccine. In September 2021, Pfizer and BioNTech shared the...

Medical Coding Slip at TX Hospital Led to COVID-19 Billing Error

by Jacqueline LaPointe

Midland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not have a primary...

2022 CPT Code Set Released, Streamlines Medical Coding for COVID-19

by Jacqueline LaPointe

The new 2022 Current Procedural Terminology (CPT) code set aims to streamline medical coding and documentation of COVID-19 vaccinations, among other updates. The code set released today by the...

AMA Updates CPT Codes for COVID-19 Vaccines

by Jacqueline LaPointe

The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster shots expected to...

COVID-19 Workflows Improve Medical Coding Efficiency Beyond Pandemic

by Jacqueline LaPointe

Getting shots into arms has been a top priority for healthcare providers since the federal government gave the green light to several COVID-19 vaccines. But while speed was key for immunizers, medical...

AMA Finalizes CPT Codes for Third Doses of Moderna, Pfizer Vaccines

by Victoria Bailey

The American Medical Association (AMA) announced that the Current Procedural Terminology (CPT) codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are effective for immediate...

AMA Unveils CPT Codes for Third Dose of Pfizer COVID-19 Vaccine

by Jill McKeon

The American Medical Association (AMA) unveiled a new Current Procedural Terminology (CPT) code for a potential third dose of Pfizer’s COVID-19 vaccine. The AMA chose to publish the code in...

Moving to the Future of Clinical Documentation Improvement

by Jacqueline LaPointe

Clinical documentation has come a long way since the days of paper medical records. Widespread adoption of EHR systems and now EHR optimizations have modernized the act of clinical documentation, and...

Key Considerations for COVID-19 Vaccine Billing and Coding

by Jacqueline LaPointe

For many providers, the end of the pandemic is in sight with the recent emergency use authorization of a COVID-19 vaccine. And while this may be true, it is just the start of a COVID-19 vaccine billing...

3 Ways to Improve Medical Coding Quality for Accurate Reimbursement

by Jacqueline LaPointe

While some have said medical coding sits quietly in the middle of the healthcare revenue cycle, it is a key step that, when done inadequately, can impact each part of the revenue cycle after it....