The American Medical Association recently announced 2 CPT Codes for reporting COVID-19 Antibody testing: (86328 and 86769)
In response to the coronavirus public health emergency, CMS has broadened access to Medicare telehealth services.
Click here for the Medicare Telemedicine Health Care Provider Fact Sheet
Click here for the Medicare Telehealth Frequently Asked Questions (FAQs)
Points to Note:
- Practices may now render full E&M services to patients in areas where there is no shortage of providers (99211-215 with appropriate modifiers appended).
With the overload of information coming in regarding coronavirus, it can become difficult to keep abreast of the changes being made.
Here are some excerpts from the Medicare Fact Sheet on CMS coverage guidelines for telehealth services dated 03/05/2020:
Telehealth and Other Communication-Based Technology Services
Beneficiaries can communicate with their doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit.
Digital record keeping is here to stay – and is evolving in leaps and bounds. The vast array of hardware and software available can be confusing to even those well versed with the current digital technology. In order to differentiate between the vast arrays of available technology, industries tend to create their own vernacular for them.
In the current healthcare scenario, every patient encounter requires to be documented – both for future reference as well as for the facility to be reimbursed for the services performed. With the increase in healthcare services, the quantum of data has also increased manifold times. Along with increasing in sheer quantity, clinical data is also becoming increasingly complex.
According to the AMA’s health insurer report card, denial rates of claims for major private payers ranged between 0.54% and 2.64%. At the same time, denial rates for Medicare stood at close to 5%. Although the percentage does not sound like too much, given the fact that billions of dollars are claimed each year, the figures for denied claims suddenly assumes gigantic proportions.
The few picture frames on the wall showcase degrees and awards that have been bestowed a long time back. The magazines on the table are mostly journals – and old ones at that. Other than the soft humming of the air conditioner and the ticking of the seconds hand on the wall clock, the room is silent.
Dermatology Coding Challenges
According to ‘Coding 2017 and beyond’, an article published in the Dermatology Times, dermatologists should be prepared for increased audits by Medicare’s CERT (Comprehensive Error Rate Testing) program, OIG, ZPIC and the RAC of their dermatology billing. In order to avoid these increased audits, dermatologists will need to submit detailed documentation which has to include histopathology with Mohs operative notes.
Your medical practice has never had it so good. The number of patients is increasing and you have enough left over after paying all your overhead expenses and bills. You even have enough left over to take that European holiday after paying off your mortgage and the household bills. Wow! You are doing well and your practice is earning money….or is it?
Globally, medical practices are facing tough financial times. The growing population coupled with the rise in new diseases is taking its toll on the healthcare system. Healthcare claims are coming under intense scrutiny, and the ever-increasing paperwork and frequently changing laws ensure compliance issues being faced by a medical practice. One of the critical challenges facing medical practices is claims denial.