CPT Codes: How to Stay Audit-Ready and Current

Healthcare fraud and abuse are hot topics right now, it’s more important than ever to get on top of new codes and keep your practice audit-ready. Knowledge is power. This handy list will help you update CPT codes and stay current. Educate providers and staff using the following auditing resources.

Stay Audit-Ready and Current with This Convenient Resource List

Sources that will provide additional information to CPT codes are:

• CPT Changes: An Insider’s View
• CPT Assistant
• Clinical Examples in Radiology

Center for Medicare and Medicaid Services (CMS):

• Medicare Claims Processing Manual, Chapter 13 – Radiology Services and Other Diagnostic Procedures
• Medicare Benefit Policy Manual, Chapter 15:  Section 80.6 - Requirements for Ordering and Following Orders for Diagnostic Tests
• Medicare National Coverage Determinations (NCD)
• Local Medicare Administrative Contractors (MACs) Coverage Determinations (LCD)
• Review the Office of Inspector General (OIG) yearly work plan

American College of Radiology (acr.org)

• Quality and Safety
• Clarification on Ordering of Diagnostic Tests Rule
• Supervision Rule
• ICD 10 CM Coding Guidelines
• Coding Topics

ICD 10 CM Guidelines and Yearly Updates

• Example: Conventions for the ICD-10-CM: 19. Code assignment and Clinical Criteria. The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.
• The Medicare Claims Processing Manual, Chapter 13, has several examples of diagnosis coding scenarios.
• AAPC Coder Software Application is an excellent and quick resource for CPT/ICD-10/HCPCS/Modifiers/CPT Assistant/Code Assist/AHA Coding Clinic and AAPC Coder Survival Guides.

Can’t get enough info about updating your CPT codes and staying forever audit-ready? I don’t blame you.

Download our free guide, Understanding the New Radiology Codes for 2017, on how to update CPT codes and accurately report your services.