Category: Blog

A View into Proposed Medicare PFS and Policy Changes for 2021

A View into Proposed Medicare PFS and Policy Changes for 2021

  The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it […]
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Do ICD-10 Codes Accurately Reflect COVID-19 Symptoms

Do ICD-10 Codes Accurately Reflect COVID-19 Symptoms?

Although the integration of big data into health care has been increasing in recent years, the coronavirus disease 2019 (COVID-19) pandemic has brought this practice to the forefront, as many hospitals and care facilities struggle to keep accurate and timely records of COVID-19 cases while adhering to changing procedures implemented at the federal level. “The use of […]
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What to Expect with the 2021 E&M Revisions

What to Expect with the 2021 E&M Revisions

  A work group put together by the American Medical Association (AMA) that also represents the AMA’s Current Procedural Terminology (CPT) Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) has put together revisions to office and outpatient evaluation management (E&M). These will take effect on January 1, 2021. So how will this affect dermatologists? Well, […]
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Billing and Documentation Guide for Patient Care During COVID-19 Pandemic

Billing and Documentation Guide for Patient Care During COVID-19 Pandemic

  The COVID-19 pandemic has brought about robust changes to the traditional practice of healthcare in the United States. In a time of social distancing and widespread quarantining, regulatory bodies, including the Centers for Medicare & Medicaid Services (CMS), have adapted to the current environment. The most critical goal was to allow healthcare providers to […]
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Proposed Rule Introduces New CPT Codes For Cardiac Shunting, EKGS, And Lung Biopsies

Proposed Rule Introduces New CPT Codes For Cardiac Shunting, EKGS, And Lung Biopsies

Coders should also take note of the new HCPCS Level II codes CMS is considering. CMS released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) on August 3, introducing 39 new CPT codes, mainly for cardiovascular services. If finalized, the new codes will go into effect January 1, 2021. The proposed update includes five new codes for […]
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Industry Voices – 3 Challenges Exposed In The New World Of Telehealth

Industry Voices – 3 Challenges Exposed In The New World Of Telehealth

The rapid rise of telemedicine in response to the COVID-19 outbreak has been critical for getting at-risk patients the care they need. In fact, many state governments are working to expand telehealth within their Medicaid programs, while also easing restrictions to allow for faster implementation. And there is evidence that this trend will not be reversed anytime soon. […]
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AMA Announces New CPT Codes for Coronavirus Testing

AMA Announces New CPT Codes for Coronavirus Testing

The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims. The newly introduced CPT codes are as follows: •86408: SARS-CoV-2 neutralizing antibody […]
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CMS Pays for Coronavirus Counseling, Other COVID-19 Billing Updates

CMS Pays for Coronavirus Counseling, Other COVID-19 Billing Updates

Provider reimbursement is now available to physicians who tell their patients to self-isolate at the time of COVID-19 testing, according to CMS. An announcement released late last week in collaboration with the Centers for Disease Control and Prevention (CDC) said CMS will leverage existing evaluation and management (E/M) payment codes to reimburse eligible providers for the coronavirus […]
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E&M Changes_ A Provocative Overview

2021 AMA E&M Changes: A Provocative Overview

Many of us have been immersed in COVID-19 and telehealth billing, coding, and the varying rules among payors of late, all the while the clock has remained ticking on the looming changes to evaluation and management (E&M) services, effective Jan. 1, 2021. It is possible, too, that there are those who have not heard of […]
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New Behavior Assessment Codes for Telehealth

New Behavior Assessment Codes for Telehealth

  There’s a slew of new health behavior assessment codes for 2020 and, good news, they’re on Medicare’s list of services you can provide via telehealth during the public health emergency (PHE) for COVID-19. Check out this rundown of the new codes and who should be using them. Assessment Codes Include Individual, Group The health […]
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