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The YES HIM Consulting blog provides medical coding news, updates, and resources for health information management and coding professionals. Subscribe to the YES HIM & Coding Insights Newsletter today.
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.
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.
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.
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.
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).
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