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Next NCCI edit update will revive thousands of code pairs, reset MUEs

09/28/2020

Prepare your practice: CMS will roll back many of the National Correct Coding Initiative (NCCI) edits that it temporarily extended during the COVID-19 public health emergency (PHE) and add a few hundred more. But the latest quarterly update, effective Oct. 1, it doesn’t spell the end of all health emergency-related flexibilities.

E/M coding scenario: Work out new MDM rules for a 99214 encounter

09/28/2020

by: Richard Scott

For the first time in more than two decades, the E/M office visit code set (99202-99215) is subject to a coding and documentation overhaul. Starting Jan. 1, 2021, you’ll find that previously vital components of code level selection — namely, the history and exam components — no longer factor into your level of decision-making. Instead, determining a level of service will come down to one of two components: Medical decision-making (MDM) or time.

High-profile taskforce urges CMS to retain telehealth changes, add HIPAA enforcement

09/28/2020

by: Roy Edroso

In a show of unity by major telehealth advocates, a Taskforce on Telehealth Policy released a series of advocacy proposals Sept. 15 that call for the retention of the major telehealth flexibilities that providers have enjoyed since the start of the COVID-19 public health emergency (PHE) in March.

New set of COVID-19 ICD-10-CM codes proposed for Jan. 1 launch

09/28/2020

by: Laura Evans, CPC

Practices may have at least five new COVID-related diagnosis codes to use starting in January 2021, according to updates announced Sept. 9. The new codes would be in addition to the ICD-10-CM code and guideline changes set to take effect Oct. 1 this year.

Flu vaccine code 90662 leads pack; watch specs on your codes to avoid denials

09/28/2020

by: Roy Edroso

Both utilization and denial rates fluctuate wildly among different flu vaccines paid for by Medicare, and the differences remain stark even among places of service.

With 99201 on the chopping block, prepare for shifting MDM elements, audit concerns

09/21/2020

by: Roy Edroso

Among other big E/M changes arriving soon, Level 1 new patient office code 99201 is going away in 2021. The transition shouldn’t hamstring your coding efforts. But keep two important elements in mind to avoid disruptions: Follow the AMA and CMS guidelines for the remaining E/M codes and resist the temptation to simply kick your former 99201 cases up a level without proper documentation.

Consider options for deaf patients in telehealth, and add a plan for prompt follow up

09/21/2020

by: Roy Edroso

Providers are required to help patients with hearing issues understand their treatment, and experts point out that the shift to telemedicine can help — or potentially complicate — the process, depending on how you approach it.

Debut of 2021 CPT codes includes 200-plus additions, dozens of revisions, deletions

09/21/2020

by: Part B News Staff

Take a first look at the CPT codes you’ll report next year for a variety of services, including the prolonged service E/M code that you can tack onto time-based E/M office visits. All told, you’ll find more than 200 new codes, 48 revisions and 52 deletions, according to a 2021 CPT data file released Sept. 1.

Some specialties should make plans to avoid to-be-deleted 99201

09/21/2020

by: Richard Scott

You’ll have one fewer E/M office visit code to report in 2021 after the AMA finalized its plan to delete 99201 from the CPT master list. While use of 99201 is trending down, some specialties that have continued to stick with it should hardwire alternative options into their 2021 coding scheme.

Avoid emerging malpractice risks when getting into the telehealth game

09/14/2020

by: Roy Edroso

Now that telehealth use is exploding, physicians and experts are thinking about the legal risks involved in treating a larger volume of patients virtually. While there’s some dispute over the threat level, it’s worth a close analysis of — and possibly some tweaks to — your encounter protocol and documentation to stay on the safe side.

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