Under the National Emergencies Act, Sections 201 and 301, the Centers for Disease Control (CDC) has issued further additions to the current list of ICD-10 codes to capture more information about the condition. The new codes went into effect January 1, 2021. The CDC has developed an ICD-10 tool, free to the public (see below), to search and summarize code use and chapter guidelines. Insurance companies will be adding these to the list of usable codes, yet, each payor will likely have their own policy for specific codes relating to testing.
Consolidated Appropriations Act Brings New Relief for Providers
After the release of the Final Rule December 2, 2020, physicians across the country were feeling the pinch of a 10% reduction in the MPFS. The Consolidated Appropriations Act, finally signed into law on December 27th, modified the Final Rule terms by revising the conversion factor to $34.8931 reflecting a 3.75% increase across the board for CY 2021. The legislation also suspended the 2% payment sequestration through March 21, 2021 and reinstated the 1.0 floor work geographic price cost index through 2023. The AMA lobbied against the implementation of the complexity code (G2211) due to its ambiguous and controversial definition, the Act will delay its use now to 2024.
COVID-19 - TESTS, TELEHEALTH & VIRTUAL CARE – What you need to know
As the Coronavirus has started to overwhelm our physicians and hospitals, we are sharing important updates to ensure you have important CMS information in this new phase of patient care. March 17th , Seema Verma, CMS Administrator issued new guidance for billing Telehealth service. This benefit has greatly expanded with regards to technology, patient location, and HIPAA rules. Prior to this release, CMS issued a public health news alert (February 13th) announcing the new HCPCS codes to be used for testing. Here’s a summary of the latest information to share with your medical teams and billing staff.
Please feel free to reach out as we are working around the clock to ensure you have the most current resources to navigate options for patient care and billing.
The Future of Evaluation & Management Services - Looking Toward 2021 - Webinar Q/A
As a follow-up to the November 21st webinar, we are pleased to share the complete list of questions submitted as part of the live broadcast. If you were unable to attend the webinar, you can click on the “read more” below to register and listen. Additional questions can be submitted by emailing jana.gil@gillcompliance.com.
PFS Final Rule for 2020
CMS PFS Proposed rule for 2020
As part of the CMS PFS Proposed rule for 2020, this summary includes most covered topics and codes utilized by our clients and subscribers. Although these policies are still in draft prior to the final rule being published early November, our abbreviated version will hopefully provide insight to upcoming changes in the physician fee schedule and telehealth approved services.
CMS Approves Virtual Visits to Streamline Patient Care
As part of an ongoing effort of CMS to streamline patient care and adopt more coverage for Telehealth services, providers will see several new coding options for CY2019. As per the Physician Fee Schedule final Rule published November 1st, CMS approved two new HCPCS codes to address established problems when utilizing telephone or internet exchange.
New Webinar Series Starting in October!
Gill Compliance Solutions and Wolters Kluwer are excited to announce a partnership offering current and future deeper dives into popular compliance topics that includes a live discussion with experts from both organizations. Please join us for the first series scheduled on October 2nd and November 8th, 2018.
Navigating Emergency Department and Critical Care Services
Presented by Nicole Benson
Date: Tuesday, October 2, 2018
Time: 1pm-2:30pm EST
This webinar will show how achieving a better understanding of high level or direct oversight Emergency department E/M can increase the accuracy of your coding and documentation to reduce risk and distinguish between high E/M levels and critical care services based on CMS guidelines.
Learning outcomes:
1. Recognize ED codes as reportable by all specialty providers performing in this setting.
2. Identify the nuances between outpatient and emergency E/M in history, exam, and medical decision-making.
3. Gain a better understanding of the differences between high level and critical care complexity as per CMS guidelines.
4. Learn how to educate your providers on identifying and greater supporting their critical care services.
This program has been pre-approved for 1.0 CEU from AHIMA and 1.0 CEU from AAPC. Registration requires a complete Name, Title, Organization and a valid business Email Address.
Click here to register
Designer Healthcare – Updates for Telehealth Services
Presented by Jana Weis
Date: Thursday, November 8, 2018
Time: 1pm-2:30pm EST
Telehealth continues to be an innovative tool to manage quality of care and patient access in the ever-changing world of healthcare. As part of the Bipartisan Budget Act of 2018, Congress loosened several regulations allowing more flexibility and coverage for Medicare and Veteran beneficiaries. Individual states are also revising laws governing the use of telemedicine to promote access to residents. No surprise, the OIG has also added telehealth to their agenda to monitor billing practices. This webinar touches on relevant policy changes for 2018 and how billable series are impacted by documentation in this setting.
Learning outcomes:
1. Understand the coverage changes since the February 2018 enactment and use of modifiers for billing.
2. Review innovative law making by states and the impact on payors.
3. Gain a better understanding of selected telehealth codes and how documentation might differ to due to HCPCS code definition.
4. Understand the current compliance risk and how payors are monitoring.
This program has ben pre-approved for 1.0 CEU from AHIMA and 1.0 CEU from AAPC. Registration requires a complete Name, Title, Organization and a valid business Email Address.
Click here to register
Teaching Physician in Critical Care Services
There are some subtle, yet important differences when teaching physicians are supervising residents in a critical care setting. Generally, for the service to be payable under the Medicare PFS, the attending physician must be present during all critical or key portions of the procedure and immediately available to furnish services during the entire service. Not only is this key for purposes of teaching supervision, but also in getting reimbursed based on CMS’s documentation guidelines.