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You can append modifiers 50 and 51 to same code but check MAC policy

07/13/2020

Question: Do you have any resources that specifically state whether modifiers 50 (Bilateral procedure) and 51 (Multiple procedures) could or should be applied on the same claim line? Our institution requests that coders apply modifier 51 for RVU allocation. It seems odd to increase the charge to 150% and also apply a 50% reduction in RVU to make it 75% the total value, if that makes sense.

AMA issues 3 new COVID lab codes, including a nasal swab assay

07/13/2020

by: Laura Evans, CPC

The AMA on June 25 issued three new CPT clinical lab codes — a new Category I microbiology code and two new proprietary “U” codes — to test patients for COVID-19.

Multiple procedures on same DOS clear payment systems with few denials

07/13/2020

by: Richard Scott

Getting paid for more than one procedure on the same date of service was not much of a challenge for providers in recent years, judging by the claims data on modifier 51 (Multiple procedures).

Boost training, revise forms and ping vendors to avoid disruptions before E/M switchover

07/06/2020

by: Julia Kyles

Look to your office processes and fire up your staff training before the new E/M coding guidelines take effect Jan. 1, 2021. If everyone in the practice has plenty of time to prepare, you can help ensure a smooth switch to the new guidelines without disrupting your practice’s revenue cycle.

Prepare for closer HIPAA scrutiny of telehealth as states and practices cautiously reopen

07/06/2020

by: Roy Edroso

HHS’ provision of telehealth waivers gave providers a boost, but as states reopen the prospect looms of a return to the old ways. That’s notable from a compliance perspective, because the HIPAA enforcement discretion that lets you perform telehealth with consumer products is likely the first policy to snap back. Make sure you’re prepared for that to happen.

Implement key steps when reintroducing remote devices into the office setting

07/06/2020

by: Kevin Duffy

As the potential for a return to office nears, health care organizations — and businesses alike — must decide what makes the most sense given their circumstances. Specifically, health care organizations need to consider privacy and security protocol for both scenarios - workers continuing to handle protected health information (PHI) from a remote location and workers returning to the office with PHI on their portable devices.

Do Stark waivers cover your rent break? Only if the break meets ‘COVID-19 purposes.’

07/06/2020

by: Roy Edroso

Question: I understand there have been Stark Law waivers issued for the COVID-19 pandemic, and that one of the waivers covers rental arrangements that are under fair market value (FMV), which are usually forbidden under Stark. The shutdown has been hard on the finances of one of our clinics, and the health system that rents space to us, knowing it will be hard to find new tenants, has offered to forgive the rent on that clinic for a month or two to help it stay open. Would the Stark waivers allow such an arrangement?

Big cities like ACP, but together Texas and Florida towns make the most claims

07/06/2020

by: Roy Edroso

The chances you're doing advance care planning (ACP) — reflected in 30-minute code 99497 and 30-minute add-on 99498 — depend a lot on your location. While Florida, Texas and California have the most claims overall, the encounters are likely to go on longer when conducted in the outer boroughs and suburbs of New York.

Has telehealth’s boom peaked? Lawmakers eye fixes, as providers wrestle with the unknown

06/29/2020

by: Roy Edroso

As many regions are reopening and returning to sense of normalcy, providers are forced to reckon with a regulatory issue that could have a significant impact on day-to-day operations: The telehealth freedoms empowered by emergency waivers may go away, or they could be curtailed, without legislative action.

Prepare for 9 ways time-based E/M rules will change the way you code

06/29/2020

by: Julia Kyles, CPC

Use a chart to show staff how the new rules for time-based office visits will affect a variety of E/M guidelines next year. Doing so now will smooth your transition to the new rules and help your practice decide if time-based coding is a good fit before the changes go into effect Jan. 1, 2021.

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