Jul 8, 2020 | Uncategorized
nnMany updates regarding a variety of different healthcare topics have been made by the Center for Disease Control in an attempt to acknowledge missing links within the previous ICD-10-CM codes. These code changes were implemented to help specify past uncertainties regarding a range of conditions. Read below to learn more about each new code that the update consisted of.nnThe Centers for Disease Control (CDC) posted the fiscal year (FY) 2021 ICD-10-CM final code changes last week. There were no changes to the proposed list of 490 new, 47 revised, and 58 invalidated codes that were released in the proposed FY 2021 Inpatient Prospective Payment System rule.nnThe final update includes hundreds of new ICD-10-CM codes including (but not limited to):n
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- 128 additions to Chapter 19: Injury, poisoning and certain other consequences of external causes for adverse effects and poisoning by fentanyl and tramadol as well as other synthetic narcotics.
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- 125 additions to Chapter 20: External causes of morbidity (V00-Y99), including more specific codes for collisions involving electric scooters and other nonmotor vehicle accidents.
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- 57 musculoskeletal codes, including several in category M24.- (other specific joint derangements) for other articular cartilage disorders, disorders of ligament, pathological dislocation, recurrent dislocation, contracture, and ankylosis.
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- 21 codes to describe withdrawal from substances including alcohol, cocaine, and opioids. For example, F10.932 (alcohol use, unspecified with withdrawal with perceptual disturbance).
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- 18 detailed codes for sickle cell anemia. New codes such as D57.213 (sickle-cell/Hb-C disease with cerebral vascular involvement) and D57.431 (sickle-cell thalassemia beta zero with acute chest syndrome) specify complications related to the condition.
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- 3 codes to capture stage 3 chronic kidney disease (CKD) in two new sub-stages. The new codes are: N18.30 (CKD, stage 3 unspecified), N18.31 (CKD, stage 3a), and N18.32 (CKD, stage 3b).
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nThe new Chapter 22: Codes for Special Purposes (U00-U85) so far includes just two codes: U07.0 (vaping-related disorder) and U07.1 (COVID-19), which took effect in the early part of this year.nnThe final update deletes code Q51.20 (other doubling of uterus, unspecified) and all codes within subcategory T40.4X- (poisoning by adverse effect of and underdosing of other synthetic narcotics), without code replacements.nnThe CDC released 23 files for the final FY 2021 ICD-10-CM code set.nnOriginal article published on healthleadersmedia.com
Jul 8, 2020 | Uncategorized
nnNew research shows the findings of how many times Chronic Care Management codes are used within different service environments. CCM codes have been on the rise recently, but denial rates have gone up as well. Read below to find out more.nnChronic Care Management (CCM) code usage has been on the rise recently. CCM codes 99490 [primary CCM], 99487 and 99489 [complex CCM] rose 23%, 78% and 285% respectively between 2017 and 2018. In 2018 CCM code 99490 was reported 4.3 million times with almost 90% of these reported in the Office setting or 3.8 million claims. That may seem like a lot but when we look at the denial rates, Office (POS 11) had only a 4% denial rate. Of the remaining 500,000 claims outside of POS 11, 225,569 claims were submitted with POS 12 (Patient’s Home) with a 7% denial rate.nnAfter the top two reported Place of Service (POS) codes the number of claims per POS drop significantly, however, the denial rate for some POS codes increase significantly. POS 21 (Inpatient Hospital) claims had a denial rate of 19%. Part B News Volume 34, Issue 24 from June 22nd has a great visual of this information in an article by Roy Edroso.nnClick here to read the article from Part B News!
Jul 2, 2020 | Uncategorized
With a true national spirit of courage, integrity, sacrifice, liberty, and independence, we wish you a Happy Independence Day! Joining hand in hand, we celebrate our liberty and thank those in service to the United States.
nWhile spending time with loved ones this weekend, please remember that COVID-19 is still spreading, so social distancing should be practiced. Masks should be worn in spaces where social distancing is not possible.n
We are proud to wish you a happy, safe, and fulfilling Independence Day!
Jul 2, 2020 | Uncategorized
How do we determine if a medical patient is new or established? The decision is ultimately made based on the professional service they were given during their visit. Read more to learn how to recognize the differences between a new patient and an established patient when COVID-19 testing.nnIn the June 29, 2020 edition of Part B News, A really great question was submitted. To summarize, there is a clinic that has been doing COVID-19 testing. A person comes in, fills out a few forms, and then receives the test. When results are ready the patient will come back to the clinic and especially if the patient’s results are positive will see a doctor. Would this patient be considered a new or established patient for the visit with the doctor?nnThis is a great question that is really important with more and more tests being conducted in all 50 states. In order to answer this question, we need to evaluate the testing. Was this patient seen by a doctor who evaluated them for the need for a test? If this is that case then this patient received professional service with a physician or other qualified health care professional (QHP) and is now an established patient.nnOr is the testing completed by a laboratory tech, nurse, or medical assistant (MA), and the patient never sees a physician of QHP? If so and there was no “professional service” then when the patient comes back for their results and is seen by a doctor then this would be considered their first professional service and therefore would be a new patient. It all comes down to a matter of the “professional service” and if the patient has had a face-to-face encounter with a physician of QHP in the past.
Jun 25, 2020 | Uncategorized
CMS is focusing on cutting red tape for healthcare providers, leading to an extreme reduction in unnecessary work hours and a huge amount of savings for businesses in the medical field. Read below for more details on the benefits that resulted from the red tape reduction.nnRegulatory reductions are expected to save providers $6.6 billion and 42 million unnecessary burden hours through 2021.nnKey TakeawaysnnTo determine where to trim red tape, CMS relied on input from 10 Requests for Information, along with listening sessions, site visits, feedback from more than 2,500 stakeholders.nnCMS says it has already removed unnecessary and burdensome regulations that have saved providers 4.4 million paperwork hours and $800 million.nnThe Centers for Medicare & Medicaid Services on Tuesday announced the creation of a new office designed to cut red tape for providers.nnThe Office of Burden Reduction and Health Informatics was launched under the CMS’ Patients Over Paperwork Initiative, and President Donald Trump’s 2017 executive order to “Cut the Red Tape,” CMS said in a media release.nnThe regulatory reductions are expected to save providers $6.6 billion and 42 million unnecessary burden hours through 2021, CMS said.nn”The work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics, and improve the beneficiary experience,” CMS Administrator Seema Verma said.nnTo determine where to trim red tape, CMS relied on input from 10 Requests for Information, along with listening sessions, site visits, feedback from more than 2,500 providers, clinicians, administrative staff, and beneficiaries, and 15,000 comments from various stakeholders.nnSo far, CMS said, the red tape reductions have:n
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- Removed unnecessary, obsolete, or excessively burdensome conditions of participation for providers saving 4.4 million paperwork hours and total projected savings to providers of $800 million annually.
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- Removed 235 data elements from 33 items on the Outcomes and Assessment Information Set assessment instrument for home health.
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- Established within the Quality Payment Program consolidated data submission for the Merit-based Incentive Payment System, removing a requirement that clinicians submit data in multiple systems.
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- Eliminated 79 measures under the Meaningful Measures Initiative, resulting in projected savings of $128 million and an anticipated reduction of 3.3 million burden hours through 2020.
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- Accelerated processing state requests to make program or benefit changes to their Medicaid programs through the state plan amendment and section 1915 waiver.
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nThe Office of Burden Reduction and Health Informatics will also focus on creating efficiencies for health informatics, particularly as it relates to interoperability and leveraging new technology and automation to create new tools that allow patients to “own” their personal health data.nn“The work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics, and improve the beneficiary experience.”nnOriginal article published on healthleadersmedia.comnn
Jun 25, 2020 | Uncategorized
As many of us in the healthcare industry have stayed particularly busy throughout the past few months, it’s important to remember the need for time-off. Even though current situations have many of us canceling or changing vacation plans, one aspect of time-off is always the stress involved with being away. Read below for more on the importance of taking time off from work.nnRecent polls show that over half of Americans do not take vacation time. Elizabeth Grace Saunders, a time management coach, wrote a great article in 2018 for Harvard Business news sitting four steps to help manage or relieve the stress that is associated with extended time-off. One of the most important being to “sign off”.nnWe constantly have work around us because of our cell phones. This can be one of the most challenging aspects for so many of us to not pick up the phone every time we hear a notification. Saunders also emphasizes the need to prioritize the items that can be put on hold while you are away.nnSo send your supervisor that time-off request that you have been holding onto and go enjoy some time away from work!nnClick here for more information on how to take the stress out of taking time off!