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Latest COVID-19 PHE extension activates Category 3 telehealth provision

11/01/2021

The COVID-19 public health emergency (PHE) will not end before Jan. 16, 2022, thanks to the renewal of the PHE that went into effect Oct. 18. Make sure your practice understands what the extension does — and does not — mean for telehealth services.

With code switch coming, refresh your principal care management approach

11/01/2021

by: Julia Kyles, CPC

Take a fresh look at principal care management (PCM) services, even if your practice currently reports them using HCPCS codes G2064 or G2065. Four new PCM codes that take effect Jan. 1, 2022 — the series of CPT codes 99424-99427 — will replace the HCPCS series and bring additional reimbursement opportunities. They also will carry over current restrictions.

Status check: Report correct E/M codes for observation services

11/01/2021

by: Joe Rivet

As the status of a patient can change during the course of a patient stay, it can be difficult for providers and coders to accurately code for observation services. Get the basics down to file your observation claims successfully.

OIG review sets guideposts, possibly, for the future of telehealth

11/01/2021

by: Richard Scott

Most virtual encounters during the COVID-induced telehealth spike involved patients who had an established relationship with a provider, and that detail may influence federal policymaking on the future coverage of tech-enabled visits, according to an OIG analysis released Oct. 20.

4 ways your Medicare enrollment may hit a snag, and how to stay clear

10/25/2021

by: Roy Edroso

Common mistakes can result in costly delays to your provider enrollment. Improve your chances of getting your enrollment right the first time by sharpening your focus on basic but often-missed Medicare requirements.

Think twice before you refer patients for urine drug tests

10/25/2021

by: Julia Kyles, CPC

Practices that use an outside lab to perform urine drug tests should make sure they follow the guidelines for the codes. The long-standing concern about improper utilization extends beyond practices and laboratories that bill for the tests; it also encompasses providers who create referrals for the tests.

Warning: OCR reports widespread breach notification failures

10/25/2021

by: Marla Durben Hirsch

Prepare for more scrutiny of your practice’s patient breach notification process, as a recent HHS Office for Civil Rights’ (OCR) HIPAA audit report reveals deficiencies in covered entities’ breach notification letters.

Take a 6-step test of your practice’s breach notification process

10/25/2021

by: Marla Durben Hirsch

No one likes to think that their practice will experience a HIPAA breach, but every practice must be ready to deploy a breach notification to patients before the 60-day deadline. A practice that doesn’t have a plan to inform patients affected by a breach of unsecured patient protected health information (PHI) will be exposed to patient anger, investigations and costly fines.

Spotted a claim error? Before appealing, consider resubmitting or reopening

10/25/2021

by: Roy Edroso

Question: I‘ve heard that, rather than waiting for a denial on a claim so I can request a formal appeal, I can ask to have my claim changed after I’ve submitted it to the Medicare administrative contractor (MAC). I’ve heard this variously called a “reopening” and a “resubmission.” My question is, how do I do it?

How to report debridement procedure with rash treatment

10/25/2021

by: Sarah Gould

Question: A wound care patient with a 25-sq-cm chronic foot ulcer presents with a new cellulitic rash, which is treated using topical medication. During the visit, the physician also surgically removes dead tissue from the ulcer. How would these services be reported in CPT?

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