Archive for June 2020
Telehealth Resource Center for Revised PHE Coding & Billing Policies Due to COVID-19
The Center for Medicare & Medicaid Services (CMS) expanded the payment guidelines for professional telehealth services provided to Medicare beneficiaries during the Public Health Emergency (PHE) declared for COVID-19 (CMS, 2020). The temporary protocol expansion was deemed necessary to aid healthcare reimbursement, and will be active only during the PHE. To keep coders and auditors up-to-date on the expanded services and reimbursement guidelines, YES HIM Consulting has gathered all the latest updates to form a telehealth resource center.
Read MoreWebinar Recap for HCCs background and a deeper dive into M.E.A.T. Criteria
In conjunction with TruCode’s Educational Series of free webinars, YES President and CEO, Karen Youmans hosted a webinar focused on HCC education and coding, and the application of the M.E.A.T. Criteria. The webinar, which was held twice due to popular demand, was attended by over 3,000 HIM professionals. If you missed the opportunity to attend either session, you can download the presentation slides here. We will recap the main points made during the webinar, and provide additional resources to help you and your organization become HCC experts.
Read MoreCOVID-19 Antigen Testing Code 87426 Available for Immediate Use from AMA
The CPT code for antigen testing was approved at a special meeting of the CPT Editorial Panel and released with a June 25, 2020, effective date.
Read MoreLearn the ICD 10 Codes for Diabetes & Other Endocrine Diagnoses
The Refresh With YES: CM Endocrine Diagnoses Webinar teaches learners the ICD 10 codes for diabetes mellitus and several endocrine diagnoses divided into 13-20-minute modules. Official coding guidelines, scenarios, and Coding Clinic topics related to the diagnosis codes for diabetes will be reviewed.
Read MoreUpdates for Medicare Fee For Service (FFS): CMS MLN Matters Special Edition Article
The Centers for Medicare & Medicaid Services (CMS) has updated Special Edition (SE) MLN Matters® article SE20011 Medicare Fee for Service response to address the changes made for the issuance of additional guidelines and waivers regarding the 2019 Novel Coronavirus, COVID-19 (CMS, 2020). This MLN Matters® Special Edition Article is for providers and suppliers who bill Medicare Fee For-Service (FFS). This includes blanket waivers for providers and suppliers, a CMS telehealth video regarding coverage of services, guidance on Beneficiary Notice Delivery, and expansion of Ambulance origins and destination modifiers.
Read MoreEverything You Need to Know About the HCC Risk Adjustment Models
There are two different models for Hierarchical Condition Category (HCC) risk adjustments: the HHS-HCC model, which covers commercial payers of all ages and determines risk payments for the current year, and the CMS-HCC model for the Medicare Advantage program and those who qualify for Medicare or patients 65 and older.
Read MoreImplement These Best Practices to Improve HCC Coding
Every healthcare organization that has Medicare patients who receive coverage and benefits through the Medicare Advantage program uses HCC coding. CMS established the HCC coding risk-adjustment model in 2004 to better predict healthcare costs for every patient and increase the accuracy in risk adjustment data for reimbursement claims (CMS, 2004). But, what is HCC coding? Hierarchical condition category (HCC) coding utilizes the ICD-10 code set to identify risks for each patient and assign risk values, or RAF scores, in value-based care models. If your coding team needs HCC coding help, here are 4 HCC coding best practices you can implement right now to see a positive impact immediately.
Read MoreReview the Temporary Physician-Based Telehealth Policies & Regulatory Revisions for COVID-19
Due to the ongoing PHE regarding the 2019 Novel Coronavirus (COVID-19) outbreak, CMS has issued an interim final rule (IFC) to provide guidance on the updated telehealth policies and other services (CMS, 2020). The current PHE has relaxed many supervision requirements, allowing for supervision to be provided through audio/video telecommunications. Telehealth policies and procedures have been expanded further, and now include E/M services for emergency department visits, critical care services, nursing facilities, End State Renal Disease (ESRD) services, psychological/neuropsychological testing, and radiation treatment management (CMS, 2020).
Read MoreReview the ICD-10-PCS 2021 Updates, Effective 10-1-2020
This article will highlight the ICD 10 PCS 2021 updates and Guideline changes, and briefly present some of the code additions for the Medical and Surgical Section.
Read MorePCI CPT Codes Online Course Covers PCI Procedures
The Refresh With YES: CPT PCI Procedures Webinar provides an overview of the CPT codes for Percutaneous Coronary Intervention (PCI) procedures divided into 14-19-minute modules. During this four-part series on PCI CPT codes, learners will receive information on various PCI procedures, including a review of the heart’s anatomy and pathophysiology of conditions that may necessitate a PCI procedure. The coding guidelines and codes for PCI are thoroughly examined, and case examples of PCI are presented. The modules offered within this course include: Anatomy and Disease Process Review, CPT Guidelines and Coding (Parts 1 and 2), and Review of Case Studies.
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