CMS updated its novel coronavirus (COVID-19) fee-for-service billing FAQs on April 23 and May 1. The updated FAQs address the appropriate use of disaster-related modifiers, remote physiological monitoring (RPM), and more.
HIM professionals are being challenged like never before. By focusing on practical steps, closely monitoring official guidance, and embracing flexibility, they can stay on top of their duties.
CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.
Clinical validation reviews and queries ensure that the documented diagnoses and clinical indicators hold up to inspection. Use these strategies to head off clinical validation reviews and improve documentation.
Like other services covered by Medicare, observation must be reasonable and necessary or, in other words, medically necessary. The physician must document that they assessed patient risk to determine that the patient would benefit from observation services.
The American Medical Association (AMA) announced on March 26 new CPT coding and reporting guidance for physicians and medical practices, intended to simplify reporting of in-person and online visit services for novel coronavirus (COVID-19) patients.
With the release of a new ICD-10-CM code for the novel coronavirus (COVID-19), hospitals now have a method to capture and report this critical disease. Although the code itself is relatively straightforward and likely won’t stir up confusion the way coding for complex diagnoses (such as sepsis) does, correctly documenting and coding COVID-19 is crucial to turning the tide on the national public health emergency.
Sepsis hospitalizations are on the rise and cost Medicare more than $40 billion in 2018, according to a U.S. Department of Health and Human Services (HHS) study.
The American Thoracic Society and Infectious Diseases Society of America recently published guidelines for the diagnosis and treatment of adults with community-acquired pneumonia. The updated guidelines are an attempt to better identify patients at risk for pneumonias due to multidrug-resistant bacteria such as Gram-negative rods and methicillin-resistant Staphylococcus aureus.
