Our revenue integrity team continually monitors announcements by the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) to bring you the most current and up-to-date coding and billing information. Since our last quarterly update, CMS and AMA have been actively publishing new information that hospitals and providers will need to review to ensure that claims coding and billing are appropriate, based upon the timing of the implementation for these updates.

It is important to review these changes and share the information with the applicable departments, as well as coding and billing staff, for possible implementation in your hospital chargemaster. Overlooking the updates puts your organization at risk for lost revenue and inaccurate coding and billing.

We have prepared a summary of changes that have occurred over the last few months, and changes being implemented in the fourth quarter of 2020. These include:

  • New Procedure/Service HCPCS Codes
  • Updates to Drugs, Biologicals, and Radiopharmaceutical HCPCS Codes
  • Special Update: IPPS Final Rule Price Transparency Requirements
  • Special Update: Price Transparency/Cash Posting COVID-19 Diagnostic Testing
  • Additional Flexibilities During the COVID-19 PHE
  • AMA Coronavirus Coding Updates
  • New CPT Codes for MAAA
  • New CPT Codes for PLA

Download the summary: CMS and AMA Fourth Quarter 2020 Coding Updates: Panacea Summary and Recommendations, to review current and up-to-date coding and billing information.