A sweeping expansion of telehealth coverage for Medicare beneficiaries is being implemented to aid in the healthcare needs of those with the coronavirus, or COVID-19. The Centers for Medicare & Medicaid Services (CMS) announced in a March 17, 2020, press release that it will make a temporary change in its reimbursement policy for telehealth services. […]
CMS is waiving the requirement in Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF 3-Day Rule Waiver) stay. This provides temporary emergency coverage of SNF services without a qualifying hospital stay for those who need to be transferred as a result of a disaster […]
Chronic Care Management (CCM) services are generally non-face-to-face services provided to Medicare beneficiaries who have multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient. The Centers for Medicare & Medicaid Services (CMS) recognizes that CCM is a critical component of primary care that promotes […]
Diagnostic Tests Medicare Part B, which includes a variety of outpatient services, covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them. Medically necessary clinical diagnostic laboratory tests are generally not subject to coinsurance or deductible. Medicare Part B also covers medically necessary imaging tests, such as computed tomography (CT) […]
Starting January 1, 2008, the Centers for Medicare & Medicaid Services (CMS) revised the procedures eligible for ASC payment annually. Furthermore, CMS issued quarterly updates to the lists of covered surgical procedures and ancillary services to set payment indicators and rates for newly introduced Level II HCPCS and Category III CPT Codes regarding ASC billing […]
There is three options Medical Coding Update for Telehealth and other communications-based technology services i.e. Telephone calls, Internet consultations, and Telemedicine exams. This information is based on guidelines from the Centers for Medicare & Medicaid Services. 2020 Medical Coding Update for Telehealth 1. Telephone Calls HCPCS code G2012 Description: Brief communication technology-based service, e.g. virtual […]
Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs covered under Medicare Part D. These plans also may offer extra benefits Original Medicare doesn’t cover. Medicare Part D also called the Medicare […]
Modifiers are two-digit symbols added to CPT procedure codes to signify that the procedure has been altered in some way. Medicare and most other payers accept modifiers; however, using modifiers correctly can be confusing, since not all payers want modifiers used the same way. Medicare defines the ASC facility’s Global Period as 24 hours from […]
Critical care is the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like conditions, renal, hepatic, metabolic, or respiratory failure, postoperative complications, overwhelming infection, or other […]
Answering a few questions will help you code correctly for laceration repairs (such as staples, sutures, or similar closure materials): Was the repair limited to the epidermis, dermis, and subcutaneous tissue, or did you need to probe more deeply?Use simple repair codes for superficial wounds (epidermis and dermis) that need only a single-layer closure. If […]
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