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Synch use of telehealth POS 10 with MAC, payer policies, schedules

01/24/2022

Get ready for a new wrinkle in telehealth billing: CMS’ place of service (POS) workgroup created a new code for telehealth encounters. But make sure your Medicare administrative contractor (MAC) and private payers are ready to process it before you append it to your claims.

After go-ahead for CMS vaccine mandate, practices may face turbulence ahead

01/24/2022

by: Roy Edroso

The Supreme Court has cleared the CMS mandate that had been suspended in 25 states, but experts predict continuing trouble getting covered health care workers, as well as some state governments, fully on board, which could lead to compliance challenges.

New in ’22, remote therapeutic monitoring covers distance therapy services

01/24/2022

by: Laura Evans, CPC

Keep an eye on five new CPT codes — 98975-98981 — for remote therapeutic monitoring (RTM) that came online Jan. 1, 2022. To start reporting them correctly, study the guidelines for the codes in the 2022 CPT manual, as well as Medicare’s discussion of them in the final Medicare physician fee schedule.

White House plan to release 1 billion COVID tests raises questions

01/24/2022

by: Roy Edroso

The Biden administration’s plan to send 1 billion COVID-19 tests to Americans may not lead to significant downstream effects on medical groups, such as an increase in patients seeking treatment for the disease, but practices should be ready to answer related questions from patients.

Tradition holds sway for coding hospital visits during the PHE

01/24/2022

by: Julia Kyles, CPC

Question: Do the new rules for coding office visits also apply to telehealth hospital inpatient or observation visits during the public health emergency (PHE)? I thought I read that CMS created a waiver for E/M visits in 2020.

Watch 2022 CPT coding updates for pulmonary rehabilitation

01/24/2022

by: Sarah Gould

Question: Will 2022 CPT codes 94625 (Professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring [per session]) and 94626 ( É ; with continuous oximetry monitoring [per session]) have the same reporting requirements as HCPCS code G0424 (Pulmonary rehabilitation, including exercise [includes monitoring], one hour, per session, up to two sessions per day)?

As PHE hit, 99201-99215 with POS 11 slipped, skyrocketed with POS 02

01/24/2022

by: Julia Kyles, CPC

Medicare Part B claims for most E/M office visits (99201-99215) reported with place of service (POS) 11 (Office) dipped in 2020 compared to claims submitted in 2019. Claims for these services fell by a total of 42.5 million visits year to year, with 99211 being the only code that experienced an increase — of 243,990 claims — during the first year of the COVID-19 public health emergency (PHE).

Patient blocks exam elements? Work with them before turning them away

01/17/2022

by: Roy Edroso

If a patient declines part of their examination — a weigh-in or disrobing, for example — you may be able to work around it, or take the opportunity to educate the patient on the necessity of the declined element. If you can’t get past it, however, make sure to proceed carefully to avoid charges of discrimination or abandonment.

Split/shared billing: 4 steps to ease adoption this year – and next

01/17/2022

by: Julia Kyles, CPC

Take steps to ease the transition to new billing rules in 2022 when physicians and non-physician practitioners (NPP) are involved in a single patient encounter. Experts predicted that Medicare’s new rule for split or shared services in facilities and for critical care services will create coding challenges for practices.

Considering app-based payments? Watch privacy concerns

01/17/2022

by: Marla Durben Hirsch

Tread carefully when accepting payment from patients via payment apps such as Venmo, PayPal and Zelle. It’s personal health information, and there’s a risk that it can be accessed by third parties.

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