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Moderna’s vaccine is expected to be shipped to providers nationwide, on the heels of Pfizer’s. A reeling nation couldn’t have asked for a better Christmas present. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for individuals 16 and older last week…
CMS has finalized a new requirement that the nation's 6,200 hospitals report information about their inventory of therapeutics to treat COVID-19. There has been a recent flurry of activity at the Centers for Medicare & Medicaid Services (CMS), with the federal agency publishing final rules for 2021 payments, giving providers…
As we near the end of what some consider the most unprecedented year in coding, there are more updates to review and decipher in preparation for 2021.   As the science around the COVID-19 pandemic continues to evolve, there remain many unknowns of post-COVID-related conditions. There is an ongoing and…
New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021.  The procedure codes introduce six specific medications that can be used for…
Dysrhythmias like complete heart block, AF, and SSS all fall into HCC 96, with a risk adjustment factor of 0.268. Our listeners and readers ask the most interesting questions! One named Dena recently wrote me and said, “I am an HCC coder, and there is a hot debate about coding…
The list will be eliminated over the course of three years. Federal officials unveiled the 2021 Outpatient Prospective Payment System (OPPS) Final Rule this week, and it heralds a long-awaited development in the initialization of the dissolution of the Medicare Inpatient-Only List. Introduced approximately 20 years ago, the List designates…
Some third-party payers have reimbursed and will continue to reimburse providers for this new CPT code; others won’t. The American Medical Association (AMA) published a new CPT® code on Sept. 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency (PHE).  The code is effective immediately: CPT 99072 – Additional supplies, materials, and clinical…
CCM appears to be positioned to be effective for improving patient care during the pandemic. Previously, we’ve discussed the numerous benefits of incorporating chronic care management (CCM) into a primary care practice. CCM is intended to help care for the sickest and most challenging Medicare patients, those with two or…