Coding Resource Center
May 2021
The proposed rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA), issued in December 2020, applies to health information maintained or transmitted by HIPAA-covered entities, including providers, health plans and clearinghouses. The goal of the proposed rule is to make information sharing more efficient during the COVID pandemic as well as […]
The Centers for Medicare & Medicaid Services (CMS) delayed the effective date for its final rule codifying how it defines “reasonable and necessary” coverage for items and services furnished under Medicare Parts A and B, through December 15, 2021. The rule also establishes a Medicare coverage pathway for innovative medical devices designated as breakthrough by […]
The Centers for Medicare & Medicaid Services (CMS) released interpretive guidance on hospital admission, discharge, and transfer notification requirements outlined in its May 2020 final rule on interoperability and patient access, which includes Medicare conditions of participation (CoPs) for hospitals, psychiatric hospitals and critical access hospitals. The new CoPs are included in the medical records […]
Since Category I codes are only released once per year, the American Medical Association (AMA) releases editorial updates to the AMA website in the form of CPT® errata and technical corrections. Errata are the revisions to the CPT® code set which are needed to correct editorial errors. Technical corrections are revisions to the CPT® code […]
April 2021
H.R. 1868, which extends the moratorium of the 2% sequestration payment adjustment, was passed by Congress and signed into law by the President on April 14, 2021. The moratorium will extend through December 21, 2021. Since the moratorium has been extended, the Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May […]
On April 15, 2021, Xavier Becerra, Secretary of Health and Human Services (HHS) announced the renewal of the public health emergency (PHE) declared due to the Coronavirus Disease 2019 (COVID-19). The PHE was originally declared on January 31, 2020; and renewed on April 21, 2020, July 25, 2020, October 23, 2020 and January 7, 2021. These extensions were in […]
Gore and Associates recently announced the first use of the FDA-approved Excluder Conformable AAA endoprosthesis with active control system in cases outside of clinical trials. This device was FDA-approved in January 2021, and was supported by findings in a clinical trial. This device introduces the company’s active control system in AAA treatment. It offers a conformable stent graft; enhanced device positioning; and optional […]
March 2021
The onset of the COVID-19 pandemic led to emergency temporary flexibilities granted for telehealth services which included traditional fee-for-service reimbursement, relaxation of allowable platforms to be utilized, and the suspension of originating sites and geographic requirements. These temporary expansions are scheduled to expire with the public health emergency (PHE). While discussions of permanent telehealth expansion […]
In the Centers for Medicare and Medicaid Services (CMS) ongoing effort to maintain budget neutrality, providers have traditionally seen an automatic sequestration of 2% in Medicare payments since implemented by the Budget Control Act of 2011. The Act set the 2% automatic and uniform reduction of Medicare payment cuts for a period of nine years. […]
CMS is delaying the start date of the first year for its Kidney Care Choices (KCC) payment model until January 1, 2022. The first performance year was to begin April 1, 2021. CMS stated it is extending the model’s implementation period to allow participants more time “to prepare to take on financial and population health […]
