How to Code Post-COVID 19 Recovery Programs

COVID 19 recovery

Of all the patients who have recovered from COVID-19, 5-15% suffer from lingering symptoms that persist weeks and even months after they test negative for COVID-19. To help these recovered patients deal with their lingering symptoms, some healthcare organizations have developed post COVID 19 recovery programs.

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Telemedicine Services Are Here to Stay Thanks to COVID-19, Shows Telehealth Billing Statistics

telehealth billing

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).

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Artificial Intelligence, Natural Language Processing, & Experienced Coders – Accurate Risk-Adjusted Payments

natural language processing

On average, organizations managed 9.70 petabytes (PB) of data in 2018; this is an explosive growth of 569 percent compared to the 1.45 PB managed two years prior (Dell Technologies, 2019). Healthcare organizations are no different, in fact, according to HIT Infrastructure (2019). Healthcare organizations have seen a health data growth rate of 878% since 2016, reaching 8.41PB on average by 2018. As you can imagine, it is physically impossible for a human to read through and analyze the tremendous amount of data collected. Healthcare organizations are rapidly turning to Artificial Intelligence (AI) and Natural Language Processing (NLP) to help collect, transform, understand, and drive decisions in a timely manner.

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Review the Temporary Physician-Based Telehealth Policies & Regulatory Revisions for COVID-19

telehealth policies

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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CMS Guidelines for Telehealth Coding & Billing During PHE

CMS guidelines for telehealth

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).

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