AMA Announces New CPT codes for Monkeypox Testing & Vaccination

The American Medical Association (AMA) has announced an update to Current Procedural Terminology (CPT®), the nation’s leading medical terminology code set for describing health care procedures and services, that includes a new laboratory test code for the orthopoxvirus and two codes for the vaccines being utilized to prevent monkeypox infection. These new CPT codes are …

Claim Editing Update: E&M Services and Modifier 25

Horizon Blue Cross Blue Shield of New Jersey will implement changes to our claim processing system to help ensure that claim payments are accurate and consistent with standard business practices. Beginning August 1, 2014, our claim system will deny certain services (including Evaluation and Management (E&M) services) when performed by the same provider on the …

Two commercial payers will stop reimbursing E & M consultation codes

Two commercial payers have announced that they will stop reimbursing E/M services consultation codes CPT 99241-99255. UnitedHealth announced in its newsletter March 2019, that it would match Medicare’s policy to stop recognizing and paying for consultations. “Effective with dates of service of June 1, 2019, UnitedHealthcare will no longer reimburse CPT codes 99241-99255 when billed …