CMS also suspended Medicare’s FFS claims payment adjustment through December. The Centers for Medicare & Medicaid Services (CMS) announced that the suspended sequestration payment adjustment of 2 percent –  which applied to all Medicare Fee-for-Service (FFS) claims from May 1 through Dec. 31, 2020, later extended through March 21, 2021…
This new law is set to take effect on Jan. 1, 2022.  In the closing days of 2020, Congress enacted and the President signed into law the "No Surprises Act."  But what does that mean for providers and patients exactly? The Act contains key protections to hold consumers harmless from…
Pay attention to dates associated with the new COVID--19 codes, Z20.822 and Z20.828, to avoid billing errors.  In December 2020, the Centers for Disease Control and Prevention (CDC) announced six new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, developed to capture the disease process of COVID-19 better.…
EDITOR'S NOTE: This article was originally published online last week, but following review by members of the editorial board to correct minor factual errors, it has been revised and republished.  IntroductionThe COVID-19 pandemic has brought about robust changes to the traditional practice of healthcare in the United States. In a time…
I was shocked, and very concerned when I recently looked at a physician department staffing sheet of a client.  Three of 12 positions had “locum” entered into the space for physician names. Digging a little deeper, I found out that since they had not been able to fill these positions,…
As CMS continues to update their policies on telehealth during the COVID-19 pandemic and the Public Health Emergency, ICD10monitor is here to continue to keep you informed on these changes.  ICD10 University will be presenting a live Telehealth Webcast on:How To Bill Telehealth Services Under the 1135 WaiverWednesday, April 15,…
Tips for improving outpatient coding, CDI and billing. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that…
An effective query process aids the hospital’s compliance with billing/coding rules. According to the American Health Information Management Association (AHIMA), Centers for Medicare & Medicaid Services (CMS), AAPC, the American Medical Association (AMA), and many other authoritative sources, a query can be a powerful communication tool used to clarify documentation in…
Are payers playing fair when it comes to evaluating cases? It seems that every day there are articles or legislation in the state and federal government intended to put a stop to so-called “surprise bills.” Fingers are pointed, blame is placed, and causes are cited to support particular positions.  Surprise…
Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as Advanced Practitioner Professionals or APPs. I get questions all…
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