Coding Resource Center
May 2020
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, section 3709, temporarily suspended the 2 percent payment adjustment pertaining to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension of this adjustment is effective from May 1, 2020 through December 31, 2020. The sequestration is expected to be reinstated on Medicare claim charges beginning […]
April 2020
OEIS Provides Interventional Procedure Recommendations During COVID-19 Pandemic The Outpatient Endovascular and Interventional Society (OEIS) announced to its members new procedural recommendations in determining what constitutes elective versus non-elective procedures during the COVID-19 pandemic. There are 18 categories that are addressed in the recommendations, and each addresses associated procedures; potential risks of postponement; and specific […]
The National Kidney Foundation (NKF) announced the publication of the Kidney Disease Outcomes Quality Initiative (KDOQI) vascular access guideline update for 2019. These guidelines are evidence-based and serve to assist practitioners in efforts to care for Chronic Kidney Disease (CKD)/End Stage Kidney Disease (ESKD) patients and their vascular access needs. The update is available online […]
March 2020
In revised MLN Matters® Article SE 1418, CMS clarifies the proper use of modifiers -59 and -XE, -XP, -XS, -XU in the existing policy. This information is for physicians and providers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries. The revision specifically includes the addition of modifiers -XE, -XP, -XS, […]
The Centers for Medicare and Medicaid Services (CMS) issued the Related Change Request (CR) Number 11628 which contains the quarterly update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits. The latest package of the NCCI PTP edits is Version 26.1 and will be implemented on April 1, 2020. CMS developed the NCCI to […]
The Office of Inspector General (OIG) has published recently added work plan items to include Medicare Part B payments to physicians for co-surgery procedures. According to CPT®, “When 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the […]
February 2020
February 6, 2020 – A survey conducted by the American Medical Association (AMA) to benchmark how various healthcare technologies are being used reveals increased integration into clinical practice by physicians. The biggest growth seen by the AMA were in the areas of telehealth, virtual visits and remote monitoring. Physicians rated improved efficiency and increased safety […]
February 6, 2020 – Centers for Medicare and Medicaid Services (CMS) issued the MLN Connects® Newsletter in which it identifies the 2020 for the Medicare Promoting Interoperability Program. This program (formerly known as the Medicare and Medicaid Electronic Health Records Incentive Program) provides incentive payments to eligible hospitals as they demonstrate meaningful use of certified […]
January 2020
January 17, 2020 – Novitas Solutions, Inc. has revised the Local Coverage Article (A53124) to reflect the 2020 CPT® changes effective on or after January 1, 2020 dates of service. Of interest is the addition of codes 34717 and 34718 to describe placement of the prosthesis: “CPT code 34717 and 34718 describe endovascular repair of […]
January 2020
January 6, 2020 – An online checklist and associated resources are now available through the American Medical Association (AMA) to assist physician practices in preparation for the upcoming changes to Evaluation and Management (E/M) services in 2021, including telemedicine. The AMA has been working with CMS to simplify E/M requirements with the goal to make […]
