Guest Post from Deborah Marsh, JD, MA, CPC, CHONC, a senior content specialist for TCI SuperCoder.
Payers don’t accept deleted CPT® codes, so your claims can’t succeed if your medical procedure codes are out of date. But do you know how often you need to update your CPT® code set? It may be more often than you think. Here are some pointers to keep in mind to give your claims their best chance at accurate payment.
Make the Biggest Transition with January Updates
Each year, a new CPT® code set is effective on January 1. For instance, for CPT® codes, 2018 codes will give way to the 2019 code set on Jan. 1, 2019.
If you use an online CPT® code search product, you’ll want to be sure that the updates are searchable January 1. It’s also helpful if the CPT® lookup includes deleted codes (marked with the deletion date) because you use the code set based on the date of service. You may need access to previous code sets to finish filing claims and for working on appeals.
Plan for These Other Regular CPT® Code Set Releases, Too
The AMA, which owns and maintains the CPT® code set, implements certain types of codes more than once a year. You should be aware of these updates and have a strategy for ensuring you have them when you need them. All specialties may see CPT® updates throughout the year, but path/lab coders need to watch for a few special categories that apply to them.
Category III and vaccine codes: Category I vaccine codes and Category III codes (temporary codes for emerging technology and services) are implemented January 1 and July 1. You’ll typically find them posted on the AMA site six months before the codes are effective, giving you time to learn how to apply them.
Category II: Category II codes are tracking codes that you may use for performance measurement programs, like MIPS. The AMA site indicates you may see release March 15, July 15, and November 15, with implementation three months after release.
Molecular pathology tier 2 codes: To help with reporting MoPath procedures, these codes go from approved to effective fairly quickly. After approval by the CPT® Editorial Panel, codes are released to the AMA site March 1, September 1, and December 1. The effective date may be as soon as one month after the release.
Administrative MAAA codes: Similar to the MoPath codes, Multianalyte Assays with Algorithmic Analyses (MAAA) see a quickened schedule. After Panel approval, the codes are released to the AMA site March 1, September 1, and December 1. The effective date is typically one month after release, although some codes are held until the major January 1 update.
PLA: The schedule for proprietary laboratory analyses (PLA) code changes is quarterly, but publication and effective dates have varied as this new-ish type of code got off the ground. For 2018, the effective dates are January 1, April 1, July 1, and October 1.
Tip: This schedule of updates throughout the year is one reason why having an online CPT® code lookup resource is a good idea. Whether it’s in addition to your paper manual or an alternative to it, automatically updated CPT® codes online ensure you have the correct codes available to you.
And Don’t Forget Corrections May Happen Any Time
The AMA posts an Errata and Technical Corrections file on its site, and you need to be sure you check it regularly or make sure your online code-lookup provider incorporates any corrections. Often the AMA posts corrections before code set implementation as people report issues they find while preparing for the transition. But updates and corrections may occur at any point in the year, so don’t assume you can let down your guard early in the year.
Bottom line: Healthcare providers need access to up-to-date CPT® codes to ensure their claims are accurate for the date of service reported. Keeping codes current isn’t as simple as updating once a year in January. Make a plan to update your coding resource or keep an eye on your online coding solution to be sure it’s doing the update work for you.
Deborah Marsh, JD, MA, CPC, CHONC, is a senior content specialist for TCI SuperCoder, working on everything from online tool enhancements and data updates to social media and blog posts. Deborah joined TCI in 2004 as a member of TCI’s respected Coding Alert editorial team.
Struggling with coursework challenges? Look no further! Hire experts to write your coursework with confidence. Our team of top-tier authors ensures outstanding results. Overcome academic obstacles and enjoy quality service at reasonable prices. Confidentiality is our priority, and discounts make it affordable for every student. Ready to excel? Write my coursework for me now!
Staying updated on CPT® codes throughout the year is crucial for accurate billing and claim success. Regularly checking for updates and corrections ensures healthcare providers have the most current information for coding procedures.
WHAT A GREAT MIRACLE (HERPES) IS GONE… It’s obvious some patients with herpes are being enslaved to the antiviral and other supplementary Orthodox medicine just to help suppress the virus and not a cure. I have been with the virus since 2018 until I was introduced by a blogger who also narrated her story online on how she was cured of Genital Herpes after using Dr Afrid Herbal Medicine. This is a year and 10 months since I was delivered from genital Herpes. All thanks to God for using this Great herbalist to heal me. I have promised to keep telling good things about Dr Afrid. Please feel free to share Your problems with him and don’t forget to tell him I did refer you to Him. Thanks. Write to him on email {drafridherbalhome@gmail.com} . He deals with Alzheimer virus, Cancer, HIV, Herpes, Genital warts, ALS, BV, UTI, Virginal infection, Hepatitis A/B, Bye..
achieving bottom-line documentation cost savings associated with transcription and document delivery, complemented with increased organization productivity via an integrated dictation, and electronic document management solution
By being familiar with the latest CPT codes, providers can ensure that their documentation is accurate and complete. This can be helpful for improving patient care and for complying with regulatory requirements.
Very Informative Blog. Thank you
It is great experience to read this article. It is great source of information. Thanks for sharing this list. Keep sharing more articles.
This was very useful information
Hey, thank you for sharing this amazing article Limit Your CPT® Code Set Updates to January?
Should DX hierarcy be based on higher HCC number or higher HCC weight value?please advice
Hey, thank you for sharing this amazing article, this helped me a lot. appreciate 🙂
Thanks for this update!!
Such a nice piece of Information
Hay, Manny Oliverez! Thank you very much for all the information regarding the Medical Billing Business cause. This is very informational and has provided more insight into something I want and how to do this step by step. Although I have extensive experience in medical laboratory billing services of more than 12 years now. I agree with this piece of information but I think, in addition to this, practitioners should now shift to modern billing solutions to keep pace with the new industrial trends. I invite you to visit my website and enlighten your concepts with the new practical innovations.
Oliverez excellent article, Thanks for this blog post. I want to thank the writer for providing such a magnificent article with each and every detail regarding medical laboratory billing services described to perfection. We have an excellent record of getting old AR accounts dating back to a year for clinical billing. This is the kind of article that will become a benchmark for us in handling our content going forward. I will go through this article again for further understanding.
Thanks for this blog this is very informative.
Very informative blog. thanks for given details about Medical billing.
Wonderful article. Keep up the good work.
keep up the good work..your blogs are very helpful.
Ascent is a full-service Business Process Outsourcing & Healthcare Services company that specializes in enhancing the financial performance of our clients by supporting their Revenue Cycle Management (RCM) and Health Information Management(HIM) requirements.
Your blog is very interesting. Thanks for sharing.
That’s why Outsourcing medical billing to medical billing companies is beneficial because Medical billing companies always take care of when to update/limit CPT codes and other changes.
This is one of best blogs for coding this also helped me out. shorturl.at/puCIT
Thank you for sharing the blog. It was very useful.
Thanks for sharing the useful blog with us.
this Blog very useful. this blog provides very useful information for healthcare
Excellent article. thanks for given details about Medical billing and CPT code.
Useful information about CPT code. Thanks for sharing this articles.
Thanks for sharing information about CPT Code Set Updates, this is important for medical billing companies, thanks for sharing.
I agree with your statement, but most of of people are using different methods for medical coding. The medical coding and billing process is an easy way to automate your medical billing services.
Thank you for sharing a report with us. Keep sharing and writing good report!
Great post, I will be sure to take a deeper dive into this topic now that I have this point of view. Appreciate the information breakdown!