How To Implement Checks and Balances in Urgent Care Coding

Last year, urgent care centers had to stretch to implement and understand the elemental changes to the coding guidelines in ICD-10-CM and changing the focus to MDM or medical decision making. This year, although the CMS guidance doesn’t look as scary, but it’s definitely worth noting on whether your team is up to speed with the alterations.

As we all have headed into the fall, it’s time to start pondering your thoughts on the annual update to ICD-10CM. Every year, the CMS and the NHS release the updated official guidelines for ICD-10-CM. This year, there are 32 deleted codes, 20 revised codes and 159 new codes with a total of 72,748 codes to choose from.

Code U09.9 is the only code added as an update for this pandemic. You have to first code the correct conditions and then use the mentioned code as a secondary diagnosis. The three common urgent care diagnoses are low back pain (M54.5), Polyuria (R35.8) and cough (R05). From 1st October, 2021, you will have to add a digit for increasing the specificity.

Having a clear understanding on how to manage everything right from start to finish lays down the corner stone in urgent care coding services. It helps you in improving your claim transparency and reduces your volume of denials considerably.

What Defines an Urgent Care Coding Company?

It is true that no one knew about the changes that American Medical Association had to do with different descriptors for CPT 2021 and office/outpatient evaluation and management codes. It was only halfway in 2021; coding experts came to know the changes that have impacted the world of urgent care billing & coding.

Proper training, understanding on how urgent care coding influence payments in the long run is the key to everything. It is also pertinent to understand how urgent coding changes with regulation amendments.

At the end of the day what you need is a quality partner that knows what it takes to upgrade your urgent care coding and billing mandates with a decisive partner. A powerful vendor must have extensive experience, understanding on how to eliminate any process loopholes and must have industry references on how they have resolved a proven urgent care billing challenge.