Enos Medical Coding

05/10/2023

May 11 is almost here! Have you made any changes that will end with the PHE?

07/12/2022

http://www.enosmedicalcoding.com/
While we're enjoying summer, Enos Medical Coding is also looking ahead to January and the 2023 CPT changes. There will be an unprecedented number of changes to the most often reported chapter of the CPT Manual. We're ready to educate your providers and staff. Take a moment to check out my summary, and plan some education for the fall. In the meantime, Happy Summer!

ancy Enos Medical Coding

08/19/2020

Telemedicine visits are here to stay, are you documenting and billing correctly? Read our FAQ's here https://sansiveri.com/

Since 1975, Sansiveri has been providing audit, accounting, forensic, financial planning, valuation, tax, strategic planning, and business counsel to businesses and their management teams throughout Southeastern New England.

07/25/2020

Telemedicine has been a lifesaver for many patients who need care, but are vulnerable. Learning the documentation requirements is important, CMS may keep some telemedicine in place, but ramp up audits to be sure there are no false payments. Do you know the documentation requirements? Enos Medical Coding can help your practice with an audit to ensure you are compliant in billing telemedicine.

In response to the telehealth expansions and increased usage during the pandemic, CMS is reviewing the temporary regulation changes it made and assessing which should become permanent, according to CMS Administrator Seema Verma.

05/20/2020

Here is a sneak peak, registration is open for tomorrow's MGMA Virtual Conference.

In this episode, we’re joined by Nancy Enos, a medical coding expert who discusses billing and reimbursement challenges since the start of the COVID-19 pandemic and ways to overcome them.

05/19/2020

Don't miss Thursday's Virtual Conference. For a preview, check out this podcast on Telemedicine billing and coding.
https://www.mgma.com/resources/revenue-cycle/%E2%80%98the-biggest-challenge-of-my-career%E2%80%99-keeping-up-w

In this episode, we’re joined by Nancy Enos, a medical coding expert who discusses billing and reimbursement challenges since the start of the COVID-19 pandemic and ways to overcome them.

04/09/2020

Medicare will pay 100% for COVID-19. Cost-sharing does not apply for COVID-19 testing-related services, which are medical visits that: are furnished between March 18, 2020 and the end of the Public Health Emergency (PHE); that result in an order for or administration of a COVID-19 test; are related to furnishing or administering such a test or to the evaluation of an individual for purposes of determining the need for such a test; and are in any of the following categories of HCPCS evaluation and management codes:

Office and other outpatient services
Hospital observation services
Emergency department services
Nursing facility services
Domiciliary, rest home, or custodial care services
Home services
Online digital evaluation and management services
Cost-sharing does not apply to the above medical visit services for which payment is made to:

Hospital Outpatient Departments paid under the Outpatient Prospective Payment System
Physicians and other professionals under the Physician Fee Schedule
Critical Access Hospitals (CAHs)
Rural Health Clinics (RHCs)
Federally Qualified Health Centers (FQHCs)
For services furnished on March 18, 2020, and through the end of the PHE, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under these payment systems should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.

For professional claims, physicians and practitioners who did not initially submit claims with the CS modifier must notify their Medicare Administrative Contractor (MAC) and request to resubmit applicable claims with dates of service on or after 3/18/2020 with the CS modifier to get 100% payment.

For institutional claims, providers, including hospitals, CAHs, RHCs, and FQHCs, who did not initially submit claims with the CS modifier must resubmit applicable claims submitted on or after 3/18/2020, with the CS modifier to visit lines to get 100% payment.

04/03/2020

New ICD-10-CM diagnosis code, U07.1, for COVID-19
In response to the national emergency that was declared concerning the COVID-19 outbreak, a new diagnosis code, U07.1, COVID-19, has been implemented, effective April 1, 2020.

04/03/2020

4/3/2020 Friday Special Medicare Update: Billing for Professional Telehealth Distant Site Services During the Public Health Emergency — Revised
This corrects a prior message that appeared in our March 31, 2020 Special Edition.
Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:
• Place of Service (POS) equal to what it would have been had the service been furnished in-person
• Modifier 95, indicating that the service rendered was actually performed via telehealth

03/31/2020

3/30/20 CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. Providers also can evaluate beneficiaries who have audio phones only.

These temporary changes will ensure that patients have access to physicians and other providers while remaining safely at home.

Providers can bill for telehealth visits at the same rate as in-person visits. Telehealth visits include emergency department visits, initial nursing facility and discharge visits, home visits, and therapy services, which must be provided by a clinician that is allowed to provide telehealth. New as well as established patients now may stay at home and have a telehealth visit with their provider.

CMS is allowing telehealth to fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice and home health.

03/23/2020

G0212 Virtual Check In will be paid by Medicare for "telephone only" communications between patients and their physicians.
CMS answered the question for me this morning through our MGMA Government Affairs office in Washington, DC.

Question: Can G0212 Virtual Check-in be billed for “telephone only” between a patient and a provider (not staff)?

Response: We are persuaded by the comments advising us not to be overly prescriptive about the technology that is used, and are finalizing allowing audio only real-time telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission.

Page 33:https://www.govinfo.gov/content/pkg/FR-2018-11-23/pdf/2018-24170.pdf

03/23/2020

Telemedicine Coding for your Medical Practice.

Enos Medical Coding is working hard to support your practice to quickly transition from traditional telemedicine reimbursement to remote Outpatient Evaluation and Management coding. We've added a list of covered CPT codes and a new FAQ sheet from our webinars last week. A Podcast is underway, and Live Webinar classes are scheduled daily (AAPC CEU's pending) www.enosmedicalcoding.com

Over the week-end we added the following resources to our website, at no charge, for you.

• List of covered telemedicine CPT codes during the COVID-19 Emergency
• List of 30 FAQs from our webinars last week
• A podcast will be uploaded within the next 2 days

Live webinar classes are scheduled daily this week. The cost to join is $100. AAPC CEU credits are pending.