What Radiology Practices Need to Know About Medicare’s Prior-Authorization Requirements

Beginning July 1, Medicare will require prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1717-FC).

Coding and Billing Resources for Coronavirus (COVID-19)

Coding and Billing Resources for Coronavirus COVID-19 Important information that provides current coding and billing updates from all of the regulatory agencies for our clients and the provider community during this public health emergency (PHE). We will continue to update this page as new guidance is received and reviewed by our senior healthcare consultants.

Modifications to Hospital Outpatient Services During COVID PHE

Telehealth Expansion for Hospitals CMS is increasing access to telehealth for Medicare patients. What this means for hospitals is they will be permitted to code and bill during the PHE for services to which allowed physicians and practitioners employed by the hospital perform a face-to-face visit via telehealth service for a registered outpatient of the […]

UPDATE: COVID-19 Antibody & Antigen Testing

In the CMS-5531-IFC dated April 30, 2020, CMS has stated COVID-19 serology antibody testing will be coverable by the Medicare program because they fall under at least one Medicare benefit category. The serology test that detects antibodies to SARS-CoV-2, the virus that causes COVD-19, may potentially aid in identifying patients who have had an immune […]

UPDATE: COVID-19 Specimen Collection for Hospitals & Physicians

In the CMS-5531-IFC Dated April 30, 2020, CMS confirmed new guidance for specimen collection services and payment. It is important for hospitals and physicians to review the applicable coding guidance summarized below and implement use for claims reporting as soon as possible. Hospital Outpatient CMS is creating a new E/M code to support COVID-19 testing […]

Clinical Diagnostic Laboratory Billing for COVID-19 Testing

We continue to monitor CMS updates for coding and billing information that will assist our client laboratories and other hospital laboratories to stay abreast of COVID-19 coding and billing during this public health emergency (PHE). CMS continues to expand billing and clarification for COVID-19 testing for clinical diagnostic laboratories.

UPDATE – Provider Telehealth Coding and Billing, effective April 1, 2020

CMS guidance for telehealth is changing rapidly. In an effort to continue providing coding and billing assistance to Panacea’s clients and the provider community during this public health emergency (PHE), we are updating the Telehealth coding and billing guidance for providers (physician, nurse practitioner, physician assistant) and have created a listing of eligible codes not […]

An Update from Panacea on COVID-19

We are all adjusting to a new reality in light of the COVID-19 pandemic. We extend heartfelt sympathy to anyone impacted by the virus, and sincere gratitude to the healthcare workers and providers on the front lines battling this unprecedented disease. We’re reaching out to update you on how Panacea is approaching this situation.

Panacea Developing News: New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), April 1, 2020

On March 18, 2020, the CDC announced the decision to implement in the United States use of new emergency temporary ICD-10-CM diagnosis code, U07.1 COVID-19, effective for use April 1, 2020 to facilitate coding of claims during this pandemic.

Coronavirus Outbreak – Institutional (Facility) Coding and Billing for Telehealth Services

Panacea is providing guidance for institutional (facility) billing during this public health emergency. Hospitals will need to take additional steps to ensure coding and billing are appropriate during this time. For the most part, billing for telehealth services has not changed with exception of the information provided below. HCPCS code Q3014 (Telehealth facility fee) describes […]