Coding Resource Center
December 2020
Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2 percent applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31, 2020. This means providers would expect to receive a 2 percent increase in their FFS claims for this time period. In exchange […]
CMS issued an Interim Final Rule with Comment Period, which established the New COVID-19 Treatments Add-on Payment (NCTAP) under the Medicare Inpatient Prospective Payment System (IPPS), effective from November 2, 2020, until the end of the Public Health Emergency (PHE) for COVID-19. The Medicare program will provide an add-on payment for eligible inpatient cases that […]
The U.S. Preventive Services Task Force (USPSTF) guidelines are the most widely used criteria for screening for abdominal aortic aneurysms (AAA). The current USPSTF guidelines recommend a one-time abdominal ultrasound in men 65 to 70 years of age with a history of smoking. Criteria from the Society for Vascular Surgery (SVS) is also used, and […]
November 2020
The American Medical Association (AMA) published an update to the CPT® code set to include two new Category I vaccine-specific codes for the coronavirus immunizations: 91300 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use 91301 – Severe acute […]
On November 2, CMS issued a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2021. This rule also provides updates to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services […]
October 2020
The Centers for Medicare and Medicaid (CMS) revised its fact sheet for ICD-10-CM, ICD-10-PCS, CPT and HCPCS Code Sets. This information is published by the Medicare Learning Network® and provides the definition, details and general payment information for each code set used to bill Medicare claims. This is a good reference for providers, suppliers, coders […]
The Centers for Medicare and Medicaid (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program. This Medicare loan program allowed CMS to make advance payments to providers to help alleviate financial burden due to cash flow issues during the COVID-19 Public Health Emergency (PHE). On March 28, 2020, CMS […]
The Critical Limb Ischemia (CLI) Global Society coalition has received approval from the Center for Disease Control (CDC) to recognize “critical limb ischemia” (CLI) and “chronic limb-threatening ischemia” (CLTI) in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective October 1, 2020. In the Alphabetic Index, CLI and CLTI are now listed under […]
Based on the CY 2019 Hospital Outpatient Final Rule (OPPS), the Hospital Price Transparency Policy will go into effect on January 1, 2021. This policy requires each operating hospital in the United States is to publish their pricing information for items and services they provide online in two ways. Comprehensive machine-readable file with all items […]
On October 2, 2021, Alex M. Azar II, 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; renewed on April 21, 2020 and then on July 25, 2020. These extensions were […]
