Apr 22, 2021 | Uncategorized
CMS proposed bi-annual ICD-10 implementation dates that would be in addition to previous coding from last October. With the ongoing COVID-19 pandemic, the industry has had to adapt and evolve quickly. Of course, with new coding comes new standards for the medical industry. Read more below to see the new CMS proposed bi-annual coding dates. nnIn the March 2021 virtual ICD-10 Coordination and Maintenance Committee meeting, the Centers for Disease Control and Prevention’s National Center of Health Statistics (CDC/NCHS) and the Centers for Medicare and Medicaid Services (CMS), announced a new proposal to introduce an April 1st implementation date for ICD-10-CM & ICD-10-PCS updates. This April 1 implementation would be in addition to our existing October 1 implementation for code set updates and revisions, and would be considered under Social Security Act section 1886(d)(5)(K)(vii).nnThis proposal is, in part, due to lessons learned from the ongoing COVID-19 Public Health Emergency (PHE) and the need for the healthcare industry to adapt quickly to rapidly evolving industry standards and the impact it has on the business of medicine. The Committee concluded with a call for public comments on this proposal. All comments must be submitted by May 7, 2021 to CMS at ICDProcedureCodeRequest@cms.hhs.gov.n
To learn about the pros and cons of the proposed bi-annual ICD-10 implementation dates, please click here.
n
Apr 16, 2021 | Uncategorized
The house has delayed Medicare 2% sequester cuts through 2021. Sequestration cuts were originally supposed to be implemented this month, however, Congress has acknowledged how detrimental this may be to providers and patients and this has ultimately prompted the extension. Continue reading below to find out more.nnPresident Biden is expected to sign the bill, which has already cleared the Senate.nnKey Takeaways:n
n
- To pay for the estimated $18 billion in delayed cuts, the bill increases the fiscal year 2030 sequester cuts.
n
- The bill also tweaks the rural health clinic provisions in the Consolidated Appropriations Act, 2021.
n
- Specifically, requirement that the payment rate for RHCs be capped at $100 per visit beginning April 1, 2021.
n
- The rate will increase gradually based on the Medicare Economic Index, but the AHA said it will remain well below typical provider-based RHC rates.
n
- Medicare also faces a separate 4% cut — about $36 billion — owing to the Pay-as-You-Go provisions that kicked in to offset the cost of the American Rescue Plan Act.
n
- The House had already passed a bill eliminating PAYGO for the stimulus bill, but the Senate did not act on it.
n
nA bipartisan U.S. House on Tuesday night voted 384-38 to delay until the end of 2021 Medicare’s reviled 2% across-the-board sequestration cuts that were supposed to take effect on April 1. The Senate passed the bill 90-2 last month and President Joseph R. Biden is expected to sign it in the coming days. To pay for the estimated $18 billion in delayed cuts, the bill increases the fiscal year 2030 sequester cuts. American Medical Association President Susan R. Bailey, MD, said the overwhelming support in Congress for delaying the cuts “acknowledges that cutting Medicare payments during a pandemic is ill-conceived policy.”nn”Physician practices are already distressed, and arbitrary 2% across-the-board Medicare cuts would have been devastating,” she said. Rick Pollack, president and CEO of the American Hospital Association, said the delay was needed while hospitals and clinicians contend with the coronavirus pandemic and ongoing vaccination efforts. “Even though our country is making great progress by vaccinating millions of people a day, it is clear that this pandemic is far from over and that there is an urgent need to keep hospitals, health systems, and our heroic caregivers strong,” Pollack said.nnAnders Gilberg, senior vice president, government affairs, at the Medical Group Management Association, said his association was “relieved that Congress heeded our call to protect medical groups from the arbitrary 2% Medicare sequester cuts through the end of 2021.” “MGMA has long opposed the sequester cuts, a tax that penalizes medical practices for Congress’ inability to meaningfully address the country’s budgetary affairs,” Gilberg said. “To reinstate the Medicare sequester in the middle of a global pandemic would threaten the viability of physician practices and adversely impact the patients they treat.”nnWith the extension in place, Gilberg urged Congress “to work in a bipartisan manner to expeditiously pass legislation that would prevent an additional 4% Medicare spending cut next year due to the budgetary effects of the American Rescue Plan.” The bill also tweaks the rural health clinic provisions in the Consolidated Appropriations Act, 2021. Specifically, the requirement that the payment rate for RHCs be capped at $100 per visit beginning April 1, 2021. The rate will increase gradually based on the Medicare Economic Index, but the AHA said it will remain well below typical provider-based RHC rates.nnThe bill also includes both Medicare-enrolled RHCs located in a hospital with less than 50 beds and RHCs that have applied for Medicare enrollment as of this date. Medicare also faces a separate 4% cut — about $36 billion — owing to the Pay-as-You-Go mandates that offset the cost of the American Rescue Plan Act. The House had already passed a bill eliminating PAYGO for the stimulus bill, but the Senate did not act on it.nnPollack said the AHA will continue to press Congress and the Biden administration for more “support, resources and tools” for the nation’s hospitals. “This includes continuing to advocate for more overall funding for the Provider Relief Fund, relief for hospitals and health systems with Medicare accelerated payments, hospital and health system priorities to be included in the upcoming infrastructure legislative package and Congressional action by the end of the year on Medicare cuts due to the effects of PAYGO,” he said.nn“To reinstate the medicare sequester in the middle of a global pandemic would threaten the viability of physician practices and adversely impact the patients they treat.”n-Anders Gilberg, MGMA nnOriginal article published on healthleadersmedia.com
Apr 8, 2021 | Uncategorized
CMS pauses payment claims submitted after April 1st until Congress passes the sequester bill. As ideas of the sequester extension have been thrown around, CMS has paused payments to minimize the volume of claims that would be reprocessed. More news should come out soon as Congress returns from recess. Read below to find more about CMS updates. nnThe House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13. A version of this article was first published April 5, 2021, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS is holding payments for claims submitted on or after April 1 in anticipation of legislation that will extend the suspension of a 2% cut (sequester) to all Medicare payments, according to a special edition of MLN Connects.nnThe Senate recently passed a bill that would eliminate the 2% sequestration of Medicare reimbursements through the end of 2021. The House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13. According to CMS, temporarily withholding payments will “minimize the volume of claims the MACs [Medicare Administrative Contractors] must reprocess if Congress extends the suspension.” MACs will reprocess any claims paid with the reduction applied, if necessary.nnExtension of the sequester is a major priority for the American Medical Association, American Hospital Association, and other physician groups who believe the 2% payment cut would financially devastate already distressed physician practices. Revenue Cycle Advisor combines all of HCPro’s Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly.nnOriginal article published on healthleadersmedia.com
Apr 8, 2021 | Uncategorized
The AMA has released new 2021 guidelines for E/M clarifications and we have the updates for the new corrections. Stay up-to-date and informed with WHP about new changes in guidelines in coding for E/M. Continue reading below to learn more.nnMarch 9, 2021 – American Medical Association (AMA) released an update to the 2021 Evaluation and Management (E&M) guidelines with clarification of definitions within the previously released guidelines. These updates, although vast, appear to really focus on the Data elements of our Medical Decision Making (MDM).nnThe updated guidelines list the following revisions.n
n
- Clarifying when reporting a test that is considered, but not selected after shared decision making.
n
- Providing a definition of “Analyzed” for reporting tests in the data column.
n
- Clarifying the definition of a “unique” test.
n
- Clarifying what is meant by “discussion” between physicians, and other qualified health care professionals and patients.
n
- Providing a definition of major vs minor surgery
n
Mar 30, 2021 | Uncategorized
This year, we celebrate National Doctor’s Day by recognizing all the hard work and sacrifices during the COVID-19 pandemic of 2020 and 2021. Doctor’s hard work and selflessness have made the biggest differences in our communities as we overcome the hardships of the past year. From frontline work to research, doctors have been working hard to keep our communities safe and healthy.nnFor this National Doctor’s Day, keep in mind the ways doctors have impacted you and how much doctors mean to our society. While we are thankful for all doctors, we would like to send a special “THANK YOU” to our clients as we celebrate YOU on this special day!
Mar 30, 2021 | Uncategorized
The AMA has released new updates for the 2021 Evaluation and Management guidelines. Stay up to date with the newest guidelines and AMA definition clarifications. Welter Healthcare Partners will also be hosting a webinar to review these changes with a link and sign-up available. Read more below to learn more. nnMarch 9,2021 – American Medical Association (AMA) released an update to the 2021 Evaluation and Management (E&M) guidelines with clarification of definitions within the previously released guidelines. These updates, although vast, appear to really focus in on the Data elements of our Medical Decision Making (MDM).nnThe updated guidelines list the following revisions.n
n
- Clarifying when reporting a test that is considered, but not selected after shared decision making.
n
- Providing a definition of “Analyzed” for reporting tests in the data column.
n
- Clarifying the definition of a “unique” test.
n
- Clarifying what is meant by “discussion” between physicians, and other qualified health care professionals and patients.
n
- Providing a definition of major vs minor surgery.
n
n Welter Healthcare Partners will be hosting one more webinar to review these changes and provide examples of when these changes will be relevant to your practice.
