The Home Health (HH) Grouper program has various data validity edits that make sure it uses consistent and accurate data when calculating payment groups on HH claims. Of these edits, currently only a principal diagnosis not assigned to a clinical group causes HH claims to be returned to the provider. Other principal diagnosis code errors aren’t returned to the provider. In some cases, this causes processing problems.
Building on its efforts to reduce administrative tasks in medicine, the American Medical Association (AMA) has released the 2023 Current Procedural Terminology (CPT) code set. Modifications to the E/M codes are among 393 editorial changes in the 2023 CPT code set, including 225 new codes, 75 deletions and 93 revisions. The new modification to the E/M codes extend to inpatient and observation care services, consultations, emergency department services, nursing facility services, home and residence services, and prolonged services.
The American Medical Association (AMA) today announced an editorial update to Current Procedural Terminology (CPT), that includes eight new codes for the bivalent COVID-19 vaccine booster doses from Moderna and Pfizer-BioNTech. The updated boosters are adapted for the BA.4 and BA.5 Omicron subvariants and the original coronavirus strain in a single dose.
The U.S. Centers for Medicare & Medicaid Services (CMS) had announced in August 2022 to only bill for monkeypox & smallpox vaccine administration when you got the vaccine at no cost from the government. CMS has now clarified that the correct instructions are to include these 3 elements on your claim, even if you get the vaccine from the government for free: