State Specific Medical Coding Resources
articles, webinars, links, files and other resources for state specific coding, reimbursement and compliance
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recent articles
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April 2nd, 2020
More Telehealth Changes Announced by CMS
| Published April 2nd, 2020
On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). See this article for further information as well as references & links to CMS information
March 31st, 2020
CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes
| Published March 31st, 2020
Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly. Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...
March 31st, 2020
COVID-19 Chiropractic Resources
| Published March 31st, 2020
COVID-19 Chiropractic Resources contains current, updated information regarding COVID-19. Included are lists of webinars, articles, websites and links pertaining to the ongoing changes.
March 30th, 2020
Spotlight: UCR Fees are Available on DRGs- Check it Out!
| Published March 30th, 2020
Check out the information page on any DRG! Look up DRGs by going to the list of DRG codes found under the Codes tab at the top of the page, or simply type in the desired DRG by using the search bar on the homepage.
When using the search bar, be sure you have the ...
March 30th, 2020
Providing Telehealth Services During COVID-19 Crisis
| Published March 30th, 2020
The rules for providing telehealth services during this pandemic have changed and some requirements have been waived. Please keep in mind that “waiving requirements” does not mean that anything goes. Another important consideration is that Medicare and private payers may likely have different rules so you need to make sure that you know individual payer requirements during this time.
April 1st, 2020
Interprofessional Consult Services
| Published March 27th, 2020 - Last Review/Update April 1st, 2020
The recent coronavirus crisis has brought non-face-to-face services to the forefront of coding and billing conversations. With the entire healthcare industry focused on caring for patients during an unprecedented and fast-moving pandemic, the goal of increasing patient access while reducing the risk of spreading infection has become paramount.
In this climate, ...
March 26th, 2020
2020 Medicare Part D Coverage Gap (AKA donut hole)
| Published March 26th, 2020
Not every Medicare drug plan has complete coverage for prescription drugs - most have some sort of coverage gap, known as the “Donut Hole”. The coverage gap is a temporary limit on coverage under the drug plan. This coverage gap will not affect everyone and begins after you have used ...
March 26th, 2020
Medicare Part D Coverage Gap (Donut Hole) Closes in 2020
| Published March 26th, 2020
Overview of the Part D coverage gap, how it got closed, what the picture looks like for 2020, and long-term outlook.
March 26th, 2020
New Biofeedback Codes to replace 90911 Eff 2020-01-01
| Published March 26th, 2020
CMS announced 90912 and 90913 are to be used starting January 2020 in place of 90911.
According to CMS MLN, these new codes, designated as “sometimes therapy”, are reported to furnish these services outside a therapy plan of care when appropriate.
Codes are permitted to be used by physicians and Non-Physician Practitioners (NPPs), ...
March 26th, 2020
LATEST COVID-19 INFORMATION FOR BILLING NON-FACE-TO-FACE SERVICES
| Published March 26th, 2020
Healthcare providers and the population at large are concerned about safe access to care considering the COVID-19 pandemic. As a result, we have received many inquiries this week about how to bill for “telehealth” services.
Let’s first address that true telehealth services have some pretty stringent requirements from CMS, including that ...
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