Part B Insider - 2018 Issue 18
Disaster Coding: Take Control of Your Catastrophe Claims
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Article Overview
This article explains how Medicare claims and related reporting may change during federally declared disasters and public health emergencies. It covers the general waiver framework, the roles of HHS and CMS, and the broad categories of billing and compliance issues that can affect providers serving affected patients. It is intended for coders, billers, compliance staff, and providers who handle claims during emergency events.
Why This Topic Matters
Disaster and emergency declarations can change how claims are processed, what requirements apply, and what information must appear on claims. Understanding the scope of these changes helps billing teams respond appropriately when services are provided under emergency conditions.
Article Sections
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Background and emergency declaration context
Introduces the federal emergency framework and the general circumstances under which disaster-related Medicare changes may apply. Summarizes the agencies and declaration process discussed in the article.
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Review How a Public Health Emergency Is Determined — and What Follows
Outlines the general sequence of a public health emergency declaration and the broad implications for federal response and waiver authority. Covers the categories of emergency information and geographic scope referenced by the article.
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Pocket These Coding Tips for Clean Claims
Discusses disaster-related claims processing considerations and general coding and billing reporting issues that may arise during a waiver period. Also addresses the types of administrative guidance CMS may provide to payers and providers.
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Fundamentals
Summarizes the kinds of information CMS may communicate when a waiver is in effect and the broader circumstances tied to disaster-related claim reporting. Focuses on administrative and operational guidance rather than clinical detail.
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Tip
Notes an additional disaster-related reporting consideration mentioned in the article and points readers toward further agency resources. Provides a brief closing reminder about checking with the local Medicare contractor.
What You Will Learn
- How federal disaster and public health emergency declarations relate to Medicare billing
- What broad categories of requirements may be affected during an emergency
- How CMS communicates general waiver-related information to payers and providers
- Which types of claims-processing considerations arise during catastrophe-related events
- What kind of administrative follow-up may be needed with a Medicare contractor
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Revenue cycle professionals
- Healthcare providers
- Practice administrators
Codes Discussed
Modifiers Discussed
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