American Medical Association (AMA) released the 2015 CPT code changes on August 28, 2014. Approximately 500 coding changes will go into effect from January 01, 2015. Physicians as well as qualified healthcare professionals will need experienced coders to understand these changes and assign proper codes for timely reimbursements.
Industry Trivia
| Practices lose a large amount of collection dollars due to assigning incorrect CPT codes |
| Effective use of EHR can help avoid down-coding as the health record system will recommend certain CPT codes based on what occurred during the patient visit |
| It has been estimated that most family physicians lose more than $10,000 per year due to undercoding |
| Failure to update coding to match CPT requirements will result in claims denials. Providers will have to make the most of reimbursement opportunities in the coming year so that CPT changes don’t affect their revenue cycle |
CPT 2015 Code Changes:
Impact of CPT 2015 Coding Changes on Practices
Practices will have to review the procedure for coding different medical procedures and anticipate how the new coding changes will impact their revenue cycle. For instance, radiology practices will have to deal with 35 new radiology and radiation oncology codes in the coming year. Many of these codes will be bundled. It is also being expected that CMS will release the Medicare values for new radiology codes as part of the 2015 Medicare Physician Fee Schedule Final Rule.
CPT 2015 will be impacting reimbursements and practice operations for orthopedic practices. It will alter the way Family Medicine practices report vaccinations, chronic care management services and arthrocentesis. Neurosurgery will get six new codes that could lead to denials if not reported correctly.
Pathologists will be bearing the biggest brunt of CPT 2015. Many codes from the existing CPT sections for therapeutic drug essays, chemistry and drug screening will be removed. Pathology coders will have to work with 107 new and 32 revised CPT codes from January 01, 2015. Cardiology practices will also witness CPT changes to Stent, FEVAR, Complex Chronic Care, MDM, ECMO, TEE and more.
What Physicians Need to Do?
With less than a month left for the implementation of CPT codes, it has become necessary for practices to interpret each change and understand how it will impact their coding. They need to ensure that their coders are trained in handling these changes so that any potential disruption to the cash flow can be avoided.
Is Outsourcing the Best Solution for Overcoming Coding Challenges?
Is your practice conversant with the guidelines, additions, revisions and deletions included in the CPT manual? To sail through revenue challenges, many practice owners are outsourcing coding and billing requirements to a third party. Billing companies such as MedicalBillersandCoders.com have a team of certified coders who are well-trained in maneuvering through these coding changes and revisions. Coding specialists at MBC have been helping physicians from 42 medical specialties overcome revenue challenges caused by CPT changes. They provide denial-free billing and coding services for ensuring health revenue returns for providers.
