Several changes have been recently made to the ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year (FY) 2021. The guidelines changes affect code assignment for conditions and symptoms related to COVID-19. The Centers for Medicare & Medicaid Services (CMS) released the updates in December 2020. Familiarize yourself with the following new and revised guidance to […]
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) broke from the usual release schedule and implemented the following six new codes related to COVID-19 on Jan. 1 and issued accompanying guidelines. Z20.822 Contact with and (suspected) exposure to COVID-19 For asymptomatic individuals with actual or suspected exposure to COVID-19, assign code Z20.822. For symptomatic […]
Five tips for improving RCM in a post-pandemic world As a result of the COVID-19 pandemic, the American Hospital Association (AHA) estimates that hospitals and health systems have lost more than $202 billion from a drop in revenue, combined with COVID-19 expenses, during the four-month period from March to June 2020. Healthcare services expenditures also dropped 38% in […]
Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
Recently, HealthLeaders hosted its first ‘Virtual Happy Hour CFO Roundtable’ sponsored by Nuance, gathering executives to address the financial and technological challenges facing the health system during the ongoing COVID-19 pandemic. The hour-long roundtable brought together healthcare executives from provider organizations ranging across the East Coast to the Midwest to delve into two key strategic […]
The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
As the nation began experiencing an uptick in COVID-19 cases this fall, a similar upswing occurred in the use of telehealth, according to the latest report from FAIR Health, an independent, nonprofit organization, which tracks commercial insurance claims as part of a healthcare cost transparency initiative. Compared to one year ago, October usage of telehealth increased […]
Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
The American Medical Association (AMA) has released updates for the second and third quarters of CPT® 2021. These changes, including new, revised, and deleted codes, will be implemented in AAPC’s Codify system as they become effective. Practices should also update their CPT® 2021 code books and electronic health record (EHR) software accordingly. Proprietary Laboratory Analyses […]
On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) finally issued the final rule for the 2021 Medicare Physician Fee Schedule (PFS). This was later than usual due to the public health emergency (PHE) and gives practices little time to prepare. However, we found that the changes from the proposed rule were […]