Medical Billing

Best Book to refer Coding Modifier Coding with Modifiers: A Guide to CPT® and HCPCS Modifier Usage, fifth edition: Softbound Edition/Year: Fifth Publisher: American Medical Association 496 pages ISBN#: 978-1-60359-893-4 Item#: OP322013 Authors: Deborah J. Grider This is book is available at discount for AMA members. For more details please visit AMA website

2020 New CPT: According to American Medical Association: There are 394 code changes in the 2020 CPT code set, including 248 new codes, 71 deletions, and 75 revisions. In making these updates, the CPT Editorial Panel considered broad input from physicians, medical specialty societies and the greater health care community. Among this year’s important additions to CPT are new medical services sparked by novel digital communication tools, such as patient portals, that allow health care professionals to more efficiently connect with patients at home and exchange information. CPT has responded by adding six new codes to report online digital evaluation services, or e-visits. These codes describe patient-initiated digital communications provided by physician or other qualified health care professional (99421, 99422, 99423), or a non-physician health care professional (98970, 98971, 98972). Other coding additions to CPT were prompted to better support home blood pressure monitoring

Who is eligible for Medicare? Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board. You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them. You or your spouse had Medicare-covered government employment. Who is eligible for Medicaid? You may qualify for free or low-cost care through Medicaid based on income and family size. In all states, Medicaid provides heal

Telehealth under the COVID-19 PHE. The patient does not have to go to an originating site and can take part in telehealth from their home. As a result, CMS does not have to pay a facility fee to an originating site. The provider is incurring practice expenses in delivering the telehealth, so CMS is paying providers for practice expense in the fee schedule when a provider, who usually practices in an office, provides telehealth services during the COVID-19 PHE. If POS 02 is used, the provider will not be paid for practice expense because the POS 02 triggers the facility provider fee schedule. CMS says in the April 6 IFC that providers who usually provide services in the office should use POS 11 for their telehealth services during the COVID-19 PHE. But the MAC needs to know that the service is telehealth. Without using POS 02 and using POS 11, however, the MAC cannot distinguish between an in-person service and a telehealth encounter. That is why CMS has indicated that modifier9

COVID 19 HCPCS Code G2023 & G2024 COVID 19 HCPCS CODES: G2023   Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source G2024   Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any The nominal specimen collection fee for COVID-19 testing for homebound and non-hospital inpatients Generally will be $23.46 SNF or for individuals whose samples will be collected by a laboratory on behalf of an HHA - $25.46. These fees are slightly higher than the typical specimen collection fees of $3 to $5, Because to reduce the exposure risk