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 (2020).
Read More
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 More
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 More
One of the biggest revenue-killers for healthcare providers is DNFB accounts. DNFB (DNFB meaning “discharged, not final billed”) – defines unbilled accounts where the patient has been discharged from the healthcare facility, but the final bill from the encounter has not been submitted. The cost effects of outstanding DNFB accounts and claims denials are staggering, and can negatively impact the providers’ cash flow and potential net revenue. So, what are the best practices to reduce DNFB days and claims denials?
Read More
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 More