Posts Tagged ‘medical coding’
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 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 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 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.
Read MoreCOVID-19 Explained: Screening for Suspected COVID-19 Infection
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 (2022).
Read MoreReview the ICD-10-CM Codes for Complications & Drug Diagnoses in 1-Hour Webinar
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 MoreCMS Guidelines for Telehealth Coding & Billing During PHE
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 MoreReview the 2021 IPPS Proposed Rule’s MS-DRG & Other ICD-10 Coding Updates
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.
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