Q: The use of telemedicine and telehealth has expanded dramatically during the COVID-19 pandemic. What should case managers be aware of when determining the most viable telemedicine options for patients?
HHS’ Health Resources & Services Administration (HRSA) launched a portal that allows organizations to submit claims for treating uninsured novel coronavirus (COVID-19) patients. Reimbursement is available for claims for testing, treatment, and inpatient admissions billed on or after February 4.
CMS and the Office of the National Coordinator for Health Information Technology (ONC) announced on April 21 the delay of the deadline for implementation of the interoperability final rule, citing the need for hospitals to focus entirely on the COVID-19 pandemic.
CMS released a one-time notification on April 24 to remind Medicare Administrative Contractors (MAC) that claims for novel coronavirus (COVID-19) diagnostic testing codes 87635 and U0002 must include modifier -QW (Clinical Laboratory Improvement Amendments [CLIA] waived test) when submitted by CLIA-waived facilities.
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
Q: When would you use the ICD-10-CM codes for opioid or marijuana use when no mental, behavioral, or other disorder is connected? I’m specifically thinking of codes F11.90 (opioid use, unspecified, uncomplicated) and F12.90 (cannabis use, unspecified, uncomplicated).
Q: Regarding patient portals, to what degree is it the individual’s responsibility to keep his or her health information private? Would the healthcare organization be liable if someone else obtained the individual’s login credentials—perhaps if the individual is known to use the same password for many applications—and accessed the records?
Medicare increased payments for patients diagnosed with the novel coronavirus (COVID-19). MLN Matters SE20015, implements provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for hospitals paid under the Inpatient Prospective Payment System (IPPS), long-term care hospitals (LTCH) PPS, and inpatient rehabilitation facilities (IRF) PPS.
The Office for Civil Rights (OCR) announced on April 9 that it will not impose penalties for violations of HIPAA rules in connection with the operation of novel coronavirus (COVID-19) testing sites during the public health emergency.
