Archive for May 2020
COVID-19 Explained: Screening for Suspected COVID-19 Infection
This article offers guidelines on how to code screening tests for suspected COVID-19 infection. There are two different kinds of tests for COVID-19: a viral test to detect a current Coronavirus infection, and an antibody test to confirm is the patient previously had COVID-19 (CDC, 2020). The CDC has issued guidance on conducting screening tests for COVID-19 and other recommendations for viral testing (2022).
Read MoreReview the ICD-10-CM Codes for Complications & Drug Diagnoses in 1-Hour Webinar
The Refresh With YES: Complications & Drug Diagnoses Webinar examines the ICD-10-CM guidelines and applicable Coding Clinic discussions with practical coding examples regarding Complications and Drug diagnoses divided into 15-18 minute modules. Learners will find out how to select the right ICD-10-CM codes for Complications & Drug Diagnoses topics, such as poisoning, adverse effects and underdosing of drugs. The four modules offered within this course include: Complications, Adverse Effects of Drugs, Poisoning, and Underdosing.
Read MoreCMS Guidelines for Telehealth Coding & Billing During PHE
The Centers for Medicare & Medicaid Services (CMS) has decided to update the CMS billing and coding guidelines for telehealth or in-home provider services due to the urgency of the current 2019-Novel Coronavirus (COVID-19) pandemic (CMS, 2020). CMS has broadened the scope for reimbursement for virtual check-ins and other digital communications with patients to safely and effectively respond to this Public Health Emergency (PHE). In the interim, telehealth services will not be limited by program restrictions put in place by Medicare (Federal Register, 2020). Evaluation and management (E/M) service codes cover these remote and communication technology-based services performed by a physician or non-physician practitioner (NPP).
Read MoreReview the 2021 IPPS Proposed Rule’s MS-DRG & Other ICD-10 Coding Updates
The 2021 Proposed Rule for Inpatient Prospective Payment System (IPPS) was released on May 11, and will be published in the May 29, 2020, Federal Register (2020). Provisions in the rule increase the Medicare IPPS rate for hospitals that report quality data and are meaningful users of EHRs by approximately 3.1%, resulting in an increase of $2.07 billion in spending. With other adjustments, the overall payment increase for inpatient hospitals will be around 1.6%. The Proposed Rule adjusts the payment rates, MS-DRG codes, and other provisions, including new ICD-10-CM and ICD-10-PCS codes.
Read MoreMaster How to Code PCS Head & Neck Procedures & Earn 1 CEU
The Refresh With YES: PCS Head and Neck Procedures Webinar dives into the definitions, procedures, and approaches for various head and neck operations divided into 16-18-minute modules. Learners will find out how to assign the right PCS code for head and neck procedures during the following four modules within this course: Craniotomy/Craniectomy Overview and Approach, Craniotomy/Craniectomy Procedures, Sinus Procedures, and Ventriculoperitoneal Shunt Procedures.
Read MoreMedicare Telehealth Services Now Included In Expanded Payment Protocol
The Centers for Medicare & Medicaid Services (CMS) has decided Medicare will expand its payment protocol for professional Medicare telehealth services provided to beneficiaries in all areas of the country, in all settings. “Telehealth, telemedicine, and related terms generally refer to the exchange of medical information from one site to another through electronic communication to improve a patient’s health” (CMS, 2020). Due to the current Public Health Emergency (PHE) declared for 2019 Novel Coronavirus (COVID-19), this expansion was considered a necessary step to assist in healthcare reimbursement and only designed to last as long as this emergency
Read MoreCOVID-19 Explained: Coding COVID-19 Possible Infection & Symptoms
This article offers guidelines on Coding COVID-19 suspected Infection & Symptoms. Symptoms of the Coronavirus, according to the CDC, include cough, shortness of breath, fever, chills, muscle pain, headache, sore throat, and loss of taste and smell (2020). The reporting guidelines dictate: In patients with acute bronchitis that has been caused by COVID-19, use codes U07.1 and J20.8. For lower respiratory infection due to COVID-19, assign codes U07.1 and J22.
Read MoreCross-Training Coders to Become Inpatient Coding Experts: Live Sessions are the Key to Success
Healthcare organizations, including coders, often struggle with a true return on investment when aiming to cross-train from outpatient to inpatient coding. There are several key differences between inpatient and outpatient coding. Inpatient coding documents a patient’s diagnosis and treatment during hospitalization, while outpatient coding generates a detailed report for diagnoses treated in one visit. Coding for inpatient vs. outpatient also requires different code sets and payment systems.
Read MoreMedicare Telemedicine Coding & Reimbursement Guidelines for COVID-19
CMS released the Medicare telemedicine coding and reimbursement guidelines for healthcare providers to use during the COVID-19 pandemic (CMS, 2020). According to the CMS Medicare Telemedicine Health Care Provider Fact Sheet, reimbursement for these visits are considered the same as in-person visits and are paid at the same rate (CMS, 2020). The U.S. Department of Health & Human Services Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs (CMS, 2020).
Read MoreTelehealth in COVID-19 Times: Virtual Services, Telemedicine Providers & HIPAA
There are 3 main types of virtual health services physicians and other professionals can provide to Medicare beneficiaries: Medicare Telehealth Visits, Virtual Check-Ins, and E-Visits (CMS, 2020). Providers such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients. See more on coding for telemedicine in response to the 1135 Waiver Authority and Coronavirus Preparedness and Response Supplemental Appropriations Act, in our previous article here.
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