Healthcare Compliance Blog

New HCPCS Code G2211 Delayed

2020 has kept healthcare reimbursement on its toes, and with 9 days of the year remaining, one thing we can count on is more change. The stimulus bill that Congress signed yesterday, Dec. 21, 2020 Consolidated Appropriations Act, 2021, includes health care provisions that change policy in the 2021 Physician Fee Schedule Final Rule, released [...]

2020-12-22T21:01:23+00:00Healthcare Compliance Blog|

Public Health Emergency (PHE) extended.

On Friday, October 2, 2020, Secretary of Health and Human services, Alex Azar II renewed the determination of a public health emergency exists.  This PHE implemented January 27, 2020 will continue for another 90 days into January 2021.  This extends the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers, including flexibility of Telehealth services, [...]

2020-10-06T16:56:04+00:00Healthcare Compliance Blog|

Appropriate Use Criteria (AUC) education and testing period extended, thank God!

August 12, 2020 CMS announced an extension the education and operations testing period for the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging through 2021.  AUC is expected to impact all providers who order advanced diagnostic imaging (computed tomography (CT), positron emission tomography (PET), nuclear medicine, and magnetic resonance imaging (MRI)) with limited exceptions. [...]

2020-09-02T17:23:42+00:00Healthcare Compliance Blog|

Clarity on CPT Code 99211 for Specimen Collection

The Interim Final Rule (IFR) released 4/30/2020 recognized the need for reimbursement for COVID -19 assessment and specimen collection. Pre-public health emergency (PHE), specimen collection was usually considered part of the office or outpatient evaluation and management (E&M) service.  The Centers for Medicare and Medicaid Services (CMS) realized early on during the PHE, that testing [...]

2020-05-27T14:12:11+00:00Healthcare Compliance Blog|

Should we use B97.29 or U07.1 to report COVID-19?

Codes and assignments are changing so quickly during this public health emergency, and in the beginning there was not a specific ICD-10-CM code for our current strain of COVID. Under the circumstances, the CDC provided a document the ICD-10-CM Official Coding Guidelines - Supplement Coding encounters related to COVID-19 Coronavirus Outbreak 2/20/2020-3/31/2020 and that document [...]

2020-05-19T19:27:24+00:00Healthcare Compliance Blog|

When to report COVID-19 exposure?

There is a lot of confusion about what ICD-10-CM codes to report for services for patients who reside in a nursing facility.  The determining factor when selecting an ICD-10-CM code should always be the documentation in the patient's medical record. Effective 4/1/2020 the CDC provided clear guidance in the form of the ICD-10-CM Official Coding [...]

2020-05-09T13:21:29+00:00Healthcare Compliance Blog|

X-Ray Modifiers

Yesterday, I had the pleasure of presenting for the American Portable Diagnostics Association's 2020 Midyear Billing Webinar.  We answered some of the burning questions members had on documentation requirements, coding quandaries and COVID-19 issues (just to name a few).  Today the questions continue to roll in.  A member wanted clarification on what modifier (50 [...]

2020-05-07T19:56:18+00:00Healthcare Compliance Blog|

New COVID-19 ICD-10 Codes

The CDC has issued an updated ICD-10-CM Official Coding and Reporting Guideline for April 1, 2020-September 30, 2020. This addition includes clear guidance to reporting COVID.  Reach out for more information.

2020-05-06T03:05:41+00:00Healthcare Compliance Blog|