Healthcare News
A total of 27 new codes for COVID-19 related conditions, circumstances, and treatment – including approved monoclonal antibodies – will be implemented on January 1, 2021. This includes six ICD-10-CM diagnosis codes and 21 ICD-10-PCS procedure codes.
The Final Rule for Hospital Outpatient Prospective Payment System (OPPS), which takes effect on January 1, 2021 was released on December 2 (CMS, 2020). The 2021 OPPS Final Rule includes updates to payment rates and changes to the APCs , including the addition of two new Comprehensive APCs (C-APCs).
The number of telehealth visits via real-time audio-video communication, as well as audio-only phone calls, skyrocketed in 2020, telehealth billing statistics show, due to the outbreak of SARS-CoV-2 and stay-at-home orders nationwide. Nearly half (43.5%) of Medicare primary visits were done via telehealth in April, compared to just 0.1% in February prior to the public health emergency (ASPE-HHS, 2020).
The Refresh With YES: ICD-10-CM HIV Coding Learning Path includes an overview of Human Immunodeficiency Virus (HIV), as well as instructions on how to assign specific ICD-10-CM codes that report the different stages of the HIV infection. Learners will explore the characteristics and pathophysiology of the HIV diagnosis, stages of the disease, and HIV treatments. Applicable guidelines and Coding Clinic articles related to HIV coding, as well as ICD-10-CM coding of medical reports and case studies, will be reviewed.
There are two different Hierarchical Condition Category (HCC) models used to calculate risk adjustments: the CMS-HCC model and the HHS-HCC model. Does your facility know how and when to use them? Our detailed HCC risk adjustment infographic explains the differences and usages for each HCC model.
The Refresh With YES: CPT Integumentary – Lesion and Wound Repair Learning Path teaches learners how to code the removal of skin lesions and repair of lacerations, divided into 12-19-minute webinars. This learning path also reviews applicable CPT guidelines, CPT coding examples, and CPT Assistant articles.
In anticipation of the release of COVID-19 vaccines, the AMA has released CPT codes for each of the two COVID-19 vaccines together with administration codes for first and second doses (AMA, 2020). AMA President Susan R. Bailey, M.D., remarked, “An effective national immunization program is key to bringing the coronavirus pandemic to an end. Correlating each coronavirus vaccine with its own unique CPT code provides analytical advantages to help track, allocate and optimize resources as an immunization program ramps up in the United States” (AMA, 2020). The AMA worked closely with the Centers for Disease Control and Prevention to develop the codes.
The Refresh With YES: ICD-10-PCS Spinal Procedures Learning Path discusses in detail how to code several spinal procedures, such as scoliosis treatment, fasciotomy, and osteotomy, divided into 11-16-minute webinars. Learners will find out how to apply ICD-10-PCS codes for spinal fusion, specifically in the cervical area of the spine. The PCS codes for the diagnosis of scoliosis and various treatments for the disorder are also discussed. This learning path provides an overview and the PCS codes for fasciotomy, osteotomy, and spinal decompression procedures. Applicable Coding Clinic articles, as well as real-world coding selection scenarios, will be reviewed.
COVID-19 vaccines that have been approved by the FDA will be covered by Medicare and most private insurers once they are available, according to CMS (2020). An IFC was released to establish that any COVID-19 vaccine that receives FDA authorization via an EUA or licensed under a Biologics License Application (BLA) will be covered at no cost to beneficiaries.
CMS has added 11 new services to the Medicare telehealth services list. These new services focus on specific neurostimulator analysis and programming, and cardiac and pulmonary rehabilitation (CMS, 2020). There have been over 135 services added to the list of payable Medicare telehealth services since CMS started expanding Medicare coverage, including ED visits and inpatient encounters. Review our Telehealth Resource Center for the full list of revised coding and billing guidelines for COVID-19. If your facility is struggling with deciphering the revised telehealth guidelines, contact YES HIM Consulting for coding support from our HIM-credentialed experts.