Unraveling Medical Coding

Coding rules for Colonoscopies are complex, especially those relating to Screening Colonoscopies.  The Cologuard test is becoming more popular as a non-invasive colorectal cancer screening test.  On January 1, 2023, CMS changed its payment policy regarding Colonoscopy after a positive Cologuard test.  This rule change has been widely misinterpreted.  This episode explains how the host, Piyush Sheth, MD, resolved the controversy.CMS Response to Dr. Sheth link:https://drive.google.com/file/d/1glZ5xEoDhm8ZYvEHZpBzkSwF_4Ch5-Hm/view?usp=sharing

The coding changes to Office / Outpatient Services implemented on January 1, 2021 and the complimentary changes to Hospital Services implemented on January 1, 2023 were designed to minimize documentation burden and allow providers to focus more on patient care. This episode discusses one major unintended consequence of these changes: the shift of the E/M CPT coding bell curves to higher levels. Topics discussed in this episode: E/M Documentation, Coding, Audit, RVUs. Don’t forget to subscribe to our podcast Books available on Amazon.com: NEW: Coding Solutions Evaluation and Management Services, 2024: Coding Solutions Evaluation and Management Services, 2024 Coding Solutions General Surgery, 2024: Coding Solutions General Surgery, 2024

These are our 4 wishes to improve documentation, coding, and healthcare from our hosts Neal Sheth and Dr. Piyush Sheth. There is also a free gift for our listeners. Click the free link below to get your free gift: https://drive.google.com/file/d/10tPZ81QkVMskZVKnUkqyzAikYQ6t58Nh/view?usp=sharing

This episode discusses the clinical issues, proper coding (using CPT and modifiers), and current payment policies regarding colonoscopies. Unfortunately, because these three aspects are intimately entwined, colonoscopy coding can get quite complex. Hosts Neal Sheth and Dr. Piyush Sheth try to simplify and clarify the concepts behind coding for colonoscopies.

2023 brings a host of changes to medical coding and billing. Dr. Piyush Sheth talks about ICD, CPT, and reimbursement changes including changes to RVU values.