Category: Blog

COVID-19 Coding_ Guidance On 11 Scenarios

COVID-19 Coding: AMA Provides Guidance On 11 Scenarios

The American Medical Association has published a COVID-19 coding scenario guide that includes a number of coding scenarios for physicians treating COVID-19 patients. The COVID-19 scenarios presented include: Patient comes to office for E/M visit, is tested for COVID-19 during the visit. Patient comes to office for E/M visit re: COVID-19 and is directed to […]
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Non-essential Surgery Guidelines

COVID-19 Causes CMS to Issue Non-essential Surgery Guidelines

CMS wants all providers to cancel or postpone all low-acuity surgeries. The Centers for Medicare & Medicaid Services (CMS) is limiting “all non-essential planned surgeries and procedures, including dental, until further notice,” according to statement the agency released March 18. This measure is designed to have a twofold effect: increase the amount of ventilators and […]
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Regulations on SNF Waivers and Telehealth

COVID-19 Impacts Regulations on SNF Waivers and Telehealth

As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
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Medical Code Change for Influenza Season

Code Change for Influenza Season 2020-2021

The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza season. Let’s start with a new CPT® code for the flu vaccine. Flu Activity Report The Centers for Disease Control and Prevention (CDC) reports that viral activity is decreasing in the United States. According to […]
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Billing and Coding for Coronavirus_ 7 things to know

Billing and Coding for Coronavirus: 7 things to know

CMS has released several fact sheets in recent weeks on billing and coding to provide guidance to healthcare organizations testing and treating patients for COVID-19, the disease caused by the novel coronavirus. Seven things to know: CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s […]
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Impacting the Healthcare Revenue Cycle

How COVID-19 Is Impacting the Healthcare Revenue Cycle

COVID-19 is creating unique healthcare revenue cycle challenges around billing and coding, patient financial responsibility, and resource allocation. As entire nations encourage their populations to stay inside to avoid COVID-19, healthcare providers are more active than ever in response to the outbreak of the novel coronavirus. This activity is having a significant impact on the […]
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Medicare Advantage and the Medicare Drug Plan

New Directions for Medicare Advantage and the Medicare Drug Plan in 2021

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare Advantage plan (MA, or Part C) and the Medicare prescription drug benefit (Part D) program. In years past, CMS has also issued a “call letter,” not subject to the regulatory process, to provide additional information for plans to use […]
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MIPS Changes

What You Need to Know About 2020 MIPS Changes

In November 2019, CMS published the 2020 Quality Payment Program Final Rule (the “2020 MIPS Final Rule Changes”). Below is a summary of some of the most notable changes to the Merit-Based Incentive Payment Program (MIPS). For a complete list of changes, please review the 2020 MIPS Final Rule or CMS’ Quality Payment Program Resource […]
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