Part B News
Proposed FY2021 ICD-10-CM update flashes nearly 500 new codes, additional changes
05/18/2020
by: Laura Evans and Julia Kyles
Coders will have hundreds of new ICD-10-CM codes to report Oct. 1, including codes for sickle cell anemia and arthritis. In addition, they’ll find a series of new options for headache codes.
E/M update: Navigate new vs. established patient distinctions during COVID-19
05/18/2020
by: Julia Kyles

You need to know when you should — and should not — disregard a patient’s established status during the COVID-19 public health emergency (PHE).

Test payment alert: Some COVID-19 tests are CLIA-waived, require modifier
05/18/2020
by: Julia Kyles
If you use Clinical Laboratory Improvement Amendment (CLIA) waivers for testing, be aware that two COVID-19 tests are now CLIA-waived and require the use of the QW (CLIA waived test) modifier.
Stick with 99211, not lab codes, if your practice collects COVID-19 specimens
05/18/2020
by: Julia Kyles
Practices should ignore the HCPCS codes that have been created for COVID-19 specimen collection and report a Level 1 established patient visit (99211) for those encounters.
For ‘Welcome to Medicare’ exam, do your own vision screen or don’t bill
05/18/2020
by: Roy Edroso
Question: The initial preventive physical examination (IPPE) requires a “visual acuity” exam that we cannot request separate payment for. Some of our providers forget this simple step, and that prevents us from getting payment for the service they have performed other than that step. If a patient wears glasses and goes regularly to ophthalmologist for their routine eye exams, can we use this to meet the requirement?
Practices see 48% jump in ‘Welcome to Medicare’ payments over 5-year stretch
05/18/2020
by: Richard Scott
The trends behind the initial preventive physical exam (IPPE), commonly referred to as the “Welcome to Medicare” visit, underscore a boon to medical practices in recent years, with more dollars pouring in and fewer denials striking down claims.
How one Pennsylvania primary care practice is planning its comeback
05/11/2020
by: Roy Edroso
Hatboro Medical Associates in Hatboro, Pa., has been around since the 1950s, serving as “a pillar of the community,” says Harris B. Cohen, M.D., a family medicine physician with the practice. It’s also in Montgomery County near Philadelphia, one of the “red” zones in Governor Tom Wolf’s reopening plan, and has had no physical appointments since the state started its lockdown on April 1.
Whether reopening now or later, communicate to patients with rules and compassion
05/11/2020
by: Roy Edroso
Keeping patients informed is always a good idea — especially so when you’re closed in a pandemic shutdown or emerging from one. Be sure you not only let your patients know you’re still there for them, but also specifically how you’ll be there for them in the future.
How one Pennsylvania primary care practice is planning its comeback
05/11/2020
by: Roy Edroso
Hatboro Medical Associates in Hatboro, Pa., has been around since the 1950s, serving as “a pillar of the community,” says Harris B. Cohen, M.D., a family medicine physician with the practice. It’s also in Montgomery County near Philadelphia, one of the “red” zones in Governor Tom Wolf’s reopening plan, and has had no physical appointments since the state started its lockdown on April 1.
4 coding scenarios to help you report COVID-19 encounters, follow-up care and more
05/11/2020
by: Julia Kyles
You don’t need a positive test result to report COVID-19 with ICD-10-CM code U07.1. Doctors may use their medical judgment to conclude that the patient has COVID-19. However, if the doctor uses terms such as “suspected” or “probable,” you should instead code based on the reason for the encounter, such as fever or suspected exposure to COVID-19
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