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Coding Guidelines for Coronavirus for Medicare Beneficiaries

In 2nd week of March 2020, Congress passed the Coronavirus Preparedness and Response Supplemental Appropriations Act. The legislation will allow physicians and other health care professionals to bill...

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New Billing Codes for Coronavirus (COVID-19) Lab Tests

Centers for Medicare & Medicaid Services (CMS) took additional actions to ensure America’s patients, healthcare facilities and clinical laboratories are prepared to respond to the 2019-Novel...

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How to code correctly for laceration repairs?

Answering a few questions will help you code correctly for laceration repairs (such as staples, sutures, or similar closure materials): Was the repair limited to the epidermis, dermis, and subcutaneous...

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Are you correctly Using 99291 and 99292 codes?

Critical care is the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess,...

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Correct Use of Modifier 50 in ASC Billing

Modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way. Modifiers are accepted by Medicare and most other payers, however, using modifiers...

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Medicare Advantage Plan Coverage and Payment Related to COVID-19

Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs...

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2020 Medical Coding Update for Telehealth

There are three options for telehealth and other communications-based technology services i.e. Telephone calls, Internet consultations, and Telemedicine exams. This information is based on guidelines...

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Understanding ASC Coding and Billing

Beginning January 1, 2008, the CMS publishes updates to the list of procedures for which an ASC may be paid each year. In addition, CMS publishes quarterly updates to the lists of covered surgical...

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Original Medicare Coverage and Payment Related to COVID-19

Diagnostic Tests Medicare Part B, which includes a variety of outpatient services, covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them....

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Billing Guidelines for Chronic Care Management (CCM)

Chronic Care Management (CCM) services are generally non-face-to-face services provided to Medicare beneficiaries who have multiple (two or more) chronic conditions expected to last at least 12 months,...

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Skilled Nursing Facility 3- Day Rule Waiver

CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay provides temporary emergency...

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Telehealth Coverage Expanded for Medicare Beneficiaries

A sweeping expansion of telehealth coverage for Medicare beneficiaries is being implemented to aid in the healthcare needs of those with the coronavirus, or COVID-19. The Centers for Medicare &...

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U.S. Healthcare System Addressing COVID-19 Patient Surge

Centers for Medicare & Medicaid Services (CMS) on 30th March 2020 issued an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum...

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COVID-19 Emergency Declaration Blanket Waivers for SNFs and NFs

The Trump Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID-19). CMS is...

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Ambulances: CMS Flexibilities to Fight COVID-19

The Trump Administration is issuing an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel...

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Telehealth in the Era of COVID-19

Sykes conducts a survey of 2,000 adults across the U.S. to understand how Americans perceive telehealth today in the era of COVID-19 and how this pandemic impacts how Americans will approach...

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Telehealth Coverage Policies during COVID-19 Pandemic

Updated on April 6, 2020, as things rapidly develop regarding what we know about COVID-19, policies around telehealth have also been developing alongside it. Below is a summary of what is covered by...

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How to increase patient collection in 2020?

As more healthcare bills go to patients themselves, many hospitals and health systems find their existing collections strategies fall short. Traditional solutions are built to collect from insurance...

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Upfront Medicare Reimbursement during COVID-19 Pandemic

Centers for Medicare & Medicaid Services (CMS) is announcing an expansion of its accelerated and advanced payment program for Medicare-participating health care providers and suppliers, to ensure...

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Newly Added CPT Codes for COVID-19 Antibody Tests

The American Medical Association (AMA) on April 10, 2020, announced updates to Current Procedural Terminology (CPT®) that include two code additions intended to report when patients receive blood tests...

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