{"id":15328,"date":"2022-04-06T17:37:26","date_gmt":"2022-04-06T17:37:26","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=15328"},"modified":"2024-12-03T07:54:33","modified_gmt":"2024-12-03T07:54:33","slug":"urgent-care-coding-updates-for-2022","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/urgent-care-coding-updates-for-2022\/","title":{"rendered":"Urgent Care Coding Updates for 2022"},"content":{"rendered":"

The Centers for Medicare & Medicaid Services (CMS) every year releases the <\/span>Medicare Physician Fee Schedule (MPFS)<\/span> to announce policy changes. In this blog, we shared important coding updates for the year 2022, applicable to urgent care services.<\/span><\/p>\n

Reduced Conversion Factor<\/span><\/h2>\n

The Protecting Medicare and American Farmers from Sequester Cuts Act were signed into law on December 10, 2021. This law addresses the reduction in the 2022 Conversion Factor set by the Physician Final Rule, decreasing the 2022 Conversion Factor by 3 percent. <\/span><\/p>\n

The new conversion factor becomes $34.61 compared to $34.89 in 2021. With the increase in Relative Value Units on most E\/M codes, the impact on 2022 rates becomes minimal.\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u00a0<\/b><\/td>\nYr. 2021<\/b><\/td>\nYr. 2022<\/b><\/td>\n<\/tr>\n
Procedure Codes<\/b><\/td>\nRVUs<\/b><\/td>\nNational Allowable<\/b><\/td>\nRVUs<\/b><\/td>\nNational Allowable<\/b><\/td>\n<\/tr>\n
99202<\/span><\/td>\n2.12<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 73.93\u00a0<\/span><\/td>\n2.14<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 74.04\u00a0<\/span><\/td>\n<\/tr>\n
99203<\/span><\/td>\n3.26<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 113.75\u00a0<\/span><\/td>\n3.29<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 113.87\u00a0<\/span><\/td>\n<\/tr>\n
99204<\/span><\/td>\n4.87<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 169.93\u00a0<\/span><\/td>\n4.9<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 169.59\u00a0<\/span><\/td>\n<\/tr>\n
99205<\/span><\/td>\n6.43<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 224.36\u00a0<\/span><\/td>\n6.48<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 224.27\u00a0<\/span><\/td>\n<\/tr>\n
99212<\/span><\/td>\n1.63<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 56.88\u00a0<\/span><\/td>\n1.66<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 57.45\u00a0<\/span><\/td>\n<\/tr>\n
99213<\/span><\/td>\n2.65<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 92.47\u00a0<\/span><\/td>\n2.66<\/span><\/td>\n $\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 92.06\u00a0<\/span><\/td>\n<\/tr>\n
99214<\/span><\/td>\n3.76<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 131.20\u00a0<\/span><\/td>\n3.75<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 129.79\u00a0<\/span><\/td>\n<\/tr>\n
99215<\/span><\/td>\n2.25<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 183.19\u00a0<\/span><\/td>\n5.29<\/span><\/td>\n $ \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 183.09\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

New POS for Telehealth<\/span><\/h2>\n

The Centers for Medicare & Medicaid Services (CMS) added a new Place of Service (POS) for telehealth services. New POS 10 represents telehealth services provided in the patient\u2019s home. The description for POS 02 has also been revised to telehealth provided other than in the patient\u2019s home. This new POS will be available for use after April 1, 2022.<\/span><\/p>\n

Addition of Modifier 93<\/span><\/h3>\n

A new modifier 93 (Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system) became effective on January 1, 2022. This modifier allows reporting of medical services that are provided via real-time interaction between the physician or other qualified health care professional and a patient through audio-only technology. <\/span><\/p>\n

Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified healthcare professional and a patient who is located away at a distant site from the physician or other qualified healthcare professional. This modifier would be used for those payers that want phone calls billed with an E\/M code instead of CPT\u2019s time-based codes 99441-99443.\u00a0<\/span><\/p>\n

Diagnosis Codes for COVID-19 Immunization<\/span><\/h3>\n

As of April 2022, CMS has announced three new diagnosis codes, including two for COVID-19 immunization status. These codes were created mainly for hospital use in calculating inpatient reimbursement. Hospitals are paid based on resources commonly used for a diagnosis.<\/span><\/p>\n