Category: Blog

COVID-19 Antibody Drugs

CMS Releases HCPCS Codes For Covid-19 Antibody Drug

  A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]
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2021 Medicare Physician Payment Schedule

Final 2021 Medicare Pay Schedule: What Physicians Need to Know

The 2021 Medicare physician payment schedule finalized an AMA-developed approach for less burdensome coding and documenting of office and outpatient evaluation and management (E/M) services. The Centers for Medicare & Medicaid Services (CMS) also extended Medicare payment for many services delivered via telehealth at least until the end of calendar year 2021, but indicated that […]
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2021 Healthcare Trends

8 Big Trends For Healthcare in 2021

As organizations adjust to new treatment types, resource needs, and customer demands, payers and providers are looking for ways to minimize costs, enhance care, create awareness, and broaden relationships. Here are the top eight trends businesses can currently track into 2021: The future of healthcare will be marked by the re-engineering of clinical care and […]
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New ICD-10-PCS Codes for COVID-19

CMS Releases New ICD-10-PCS Codes for COVID-19

New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021. The procedure codes introduce six specific medications that can be used for treatment of COVID-19. The drugs […]
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Hospital Claim Denials

Hospital Claim Denials Up for Most, Driven by Prior Authorizations

  Hospitals and health systems are facing a growing volume of claim denials, with private plan prior authorization issues driving the recent increase, according to a new report from the American Hospital Association (AHA). For the report, AHA surveyed more than 200 hospitals and health systems in 2019 to understand the impacts utilization management practices employed by […]
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Telemedicine Risk Management

Managing Telemedicine Risks During the COVID-19 Pandemic

As more US patients are diagnosed with COVID-19, a number of industry associations have recognized telemedicine—the practice of using technology to deliver healthcare remotely—as a viable means to give patients access to care and minimize exposure to the disease. Adoption of virtual care has increased as the pandemic has significantly imperiled the country and the […]
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2021 Physician Fee Schedule

Expect Give and Take in 2021 Physician Fee Schedule

After a slight delay, the Centers for Medicare & Medicaid Services (CMS) has finalized 2021 payments and policies under the Medicare Physician Fee Schedule (PFS). Most notably, the final rule makes permanent several telehealth flexibilities introduced during the public health emergency (PHE) for the COVID-19 pandemic while also significantly overhauling reimbursements for many services related […]
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HIPAA Privacy Rule Modifications

HHS Proposes HIPAA Modifications

The Department of Health and Human Services on Thursday unveiled proposed changes to the Health Insurance Portability and Accountability Act Privacy Rule that federal officials say will improve patient access to their medical records, encourage coordinated care and cut red tape. “Our proposed changes to the HIPAA Privacy Rule will break down barriers that have stood in […]
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