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Professional Coding Corner

COVID-19 vaccine distribution has begun, and with it comes countless challenges for medical practices and critical access hospitals nationwide: Storing the vaccine correctly, avoiding waste, scheduling patient appointments for initial and secondary doses, answering patient questions, and more. That’s in addition to managing the daily grind of ensuring revenue integrity. This month, we’ve compiled five news stories to help providers stay abreast of industry changes. As we head into the remainder of the winter, what are your concerns, and how can Physician Practice Resources help? Email us at info@ppr-corp.com. Most importantly, stay safe out there.

COVID-19 coding continues to evolve

Codes and coding guidelines related to COVID-19 are continually changing, and coders must remain vigilant to ensure compliance. For starters, there are updated ICD-10-CM guidelines related to COVID-19 that include information about manifestations, screening, personal history, encounter for antibody testing, and more. In addition, there’s a new CPT code for the Janssen single-dose vaccine (91303) and its associated administration code (0031A). These new codes are effective upon FDA approval of the vaccine product. Note that the American Medical Association provides a guide in helping providers select the correct codes.

E/M changes went live January 1, 2021

As of January 1, providers no longer use the three key components (history, exam, and medical-decision making) to select an E/M level for outpatient office-based E/M services. Now, they select a code based on time or medical-decision making. The Medical Group Management Association (MGMA) provides a helpful resource to support practices as they strive to comply with these monumental changes.

New MGMA special report captures industry challenges

A recent MGMA special report cites several challenges that today’s healthcare providers face. Here are just a few:

  • Correctly coding and billing telehealth and telephone visits
  • Decreasing reimbursement
  • Deferred care complications
  • Increasing costs (especially for personal protective equipment)
  • Natural disasters
  • Staff mental health challenges
  • Staff shortages

The report provides advice on how to address these challenges, and it also looks ahead to what will be on the radar throughout the reminder of 2021, namely new key metrics, patient monitoring, sustaining morale, reassessing space needs, and forging a path to value.

Practices must prepare for COVID-19 vaccine distribution

As medical practices prepare to distribute the COVID-19 vaccine, they must be prepared to answer patient questions, build confidence, and keep patients informed of statewide developments. The CDC provides several helpful tips to help practices engage with patients as well as a PDF of quick answers for healthcare professionals to common questions people may ask about the COVID-19 vaccine. Also check out the CDC’s COVID-19 vaccination communication toolkit that can help medical practices develop communication strategies.

Patient portals should be another area of attention. These portals are only useful in distributing information about the vaccine if patients use them. Pay close attention to older Americans who may not have access. Practices may want to use targeted outreach strategies specifically to reach this population, letting them know where and how to receive the vaccine.

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