CPT® 2021 includes 206 new codes, 69 revised codes, and 54 deleted codes. All sections of CPT® received changes in codes and guidelines, except Anesthesia. The most significant changes are to codes for office/other outpatient evaluation and management (E/M), prolonged services, breast repair and reconstruction, cardiovascular shunting procedures, and COVID-19 testing. Here is an overview […]
The base Medicare reimbursement rate for COVID-19 tests using high throughput technology will decrease to $75 next year unless labs can process results in 2 days or less. CMS will reduce the base Medicare reimbursement rate for COVID-19 tests done by laboratories using high throughput technology, according to a new announcement. The announcement made late last […]
The pandemic continues to impact Medicare reimbursement. COVID-19 continues to make news on the regulatory front with two new directives from the Centers for Medicare & Medicaid Services (CMS), centering on testing for the deadly coronavirus and formal coding edits for the Medicare Administrative Contractors (MACs) on payments with the CS modifier. There’s a new […]
The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services. The code set released earlier today modified E/M office visit codes 99201 through 99215 to eliminate history and physical exam as […]
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 […]
The Centers for Medicare & Medicaid Services (CMS) implemented 12 new ICD-10-PCS codes to allow Medicare and other insurers to identify the use of the therapeutics Remdesivir and Convalescent plasma for treating hospital inpatients with coronavirus (COVID-19). The new codes, effective Aug. 1, are: ICD-10-PCS Code XW013F5 – Introduction of Other New Technology Therapeutic Substance […]
Deemed the epicenter of COVID-19 deaths by many, skilled nursing facilities and other nursing home providers are now on the verge of collapsing without financial help, industry leaders say. Skilled nursing facilities are on the verge of collapsing due to historic underfunding and the financial repercussion of the COVID-19 crisis, according to a new report from the […]
Waivers, modifiers, lab tests, multiple diagnosis codes…the layers and specifics of COVID-19 coding cannot be overlooked when ensuring appropriate reimbursement and safeguarding claims against third-party payer audits. As hospitals and healthcare organizations begin to assess the required steps necessary to prepare for the transition back to a pre-COVID-19 operating environment, apart from timelines and state […]
The healthcare system is facing an unprecedented crisis, but accurate COVID-19 coding and billing can help providers weather the storm and prepare for future outbreaks. The COVID-19 pandemic is putting strain on the healthcare system, but accurately capturing data and documenting cases of the novel coronavirus can help ease the burden on providers. COVID-19 […]