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You’ll find Medicare's new and revised rules for hospital visits, nursing facility visits, prolonged services and split/shared visits in CMS 100-04, Change Request 13064, released February 9. The update includes more information on documenting time-based visits but is silent on component-based split/shared billing.
 
The Biden administration has announced its intention to end the U.S. COVID-19 public health emergency (PHE) on May 11, 2023. In place since Jan. 31, 2020, the PHE has allowed numerous flexibilities within the Medicare program that will need to be either extended or wound down. 
Starting July 1, practices will have a diverse collection of new CPT Category III codes to use for procedures including pulmonary artery denervation, two-chamber leadless pacemaker implant and percutaneous sacroiliac joint fusion.
A practice management company risks disruptive investigations, bad publicity and costly settlements if it is accused of submitting fraudulent claims for a provider.
 
Come April 1, coders will have additional code options to further capture social determinants of health (SDOH) and abuse and neglect, as CDC released upcoming changes to both the code set and official guidelines on Jan. 9.
 

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