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).
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I’m sure everyone has heard the saying, “the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final rule on April 30, offering another round of coding and documentation updates related to telehealth during the public health emergency.
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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.
Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates, effective July 2020 (with some retroactive changes). Please review the updates for possible implementation in your hospital chargemaster and/or review by applicable department, coding and billing staff.
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As many of you have heard, there are major changes coming to evaluation and management (E&M) codes in 2021. The changes were finalized in the 2020 Physician Final Rule.
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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 […]
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 […]
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 […]
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.