Q: For the new 2017 epidural injection CPT® codes, the longer-term injections (63234-62327) indicate they are to be used if they are administered on more than a single calendar day. What if we start the administration at 10 p.m. and then discontinue the administration at 1 a.m.? That would be two calendar days. Can we used those codes or should we use the shorter-term injection series (62320-62323)?
After missing a proposed fall start date, CMS announced last week that its Medicare Part B drug payment model from the Center for Medicare and Medicaid Innovation will not be going forward.
Jugna Shah, MPH, and Valerie A. Rinkle, MPA, look at comprehensive APC (C-APC) expansion for 2017 and how that will lead to many new codes to be included in C-APCs. They also look at CMS’ new site-neutral payment policies for 2017 included in the latest OPPS final rule.
Coders have many more options to report diagnoses of the foot in ICD-10-CM, with the ability to include laterality, location, and other details related to the injury. Review the bones of the feet and tips for additional documentation details to note when choosing codes for foot fractures.
The 2017 OPPS final rule brings the end of modifier –L1 for separately reportable laboratory tests, along with changes to CMS’ packaging logic. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review how these changes will impact providers.
Chronic care management codes were adopted by CMS in 2015, but relatively few providers use them. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, writes about the criteria needed to code and bill these services, as well as how coders can work with providers to ensure documentation supports the codes.
CMS made no changes for quality measures related to 2019 payment determinations that require reporting next year in the 2017 OPPS final rule. However, for payment determinations in 2020 and subsequent years, CMS is finalizing proposals on seven quality measures.
Drug administration services are one of the most commonly coded and billed services, but that does not mean providers always include complete documentation. Review what physicians and nurses should be including in order to report the most accurate codes.
