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 […]
In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine. AMA assigned Category 1 CPT code 91302 to the vaccine manufactured by the Cambridge, United Kingdom (UK) company, as well as vaccine administration CPT codes […]
A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]
Now that a COVID-19 vaccine is approved, providers need to execute a medical billing and coding strategy to sustain vaccination efforts. For many providers, the end of the pandemic is in sight with the recent emergency use authorization of a COVID-19 vaccine. And while this may be true, it is just the start of a COVID-19 vaccine […]
New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021. The procedure codes introduce six specific medications that can be used for treatment of COVID-19. The drugs […]
CPT® 2021 includes 206 new codes, 69 revised codes, and 54 deleted codes. All sections of CPT® received changes in codes and guidelines, except Anesthesia. The most significant changes are to codes for office/other outpatient evaluation and management (E/M), prolonged services, breast repair and reconstruction, cardiovascular shunting procedures, and COVID-19 testing. Here is an overview […]
The American Medical Association (AMA) introduced a new CPT® code, aimed at covering additional provisions to ensure patient and provider safety during a public health emergency (PHE). CPT 99072: Additional supplies, materials, and clinical staff time beyond what is typically included in an office visit or non-facility service(s), when performed during a PHE due to […]
Coding professionals face a new landscape in today’s evolving job market where productivity and results are the main drivers behind the operational and financial health of the organizations they support. With artificial intelligence (AI) and natural language processing (NLP) advancing at a rapid rate, it is imperative that coding professionals remain competitive and are equipped […]
As 2020 winds down, typically everyone from newscasters to sports reporters to anyone with a Twitter handle will write a “Year in Review” article, adding their predictions for the upcoming year. So we thought we would do the same – take a look back and also a look ahead. 2020 has been a fascinating year. […]
When billing for outpatient telehealth services during the COVID-19 PHE, providers should use the POS code that they would have otherwise used had the service been provided in person. Q: What place of service (POS) codes and modifiers should be reported on physician claims for wound care services performed via telehealth during the novel coronavirus […]










