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October 2021

As we write this month’s Professional Coding Corner, HHS extended its public health emergency for the seventh time since the beginning of the COVID-19 pandemic. Clearly, the pandemic is far from over, yet medical practices and rural hospitals nationwide continue to provide high-quality patient care even despite ongoing challenges. This month, we’ve compiled five news stories to help providers stay abreast of industry changes. As we look ahead, what are your concerns, and how can Physician Practice Resources help? Email us at info@ppr-corp.com. Most importantly, stay safe out there.

There’s a new telehealth place of service code for Medicare. Are you ‘in the know?’

Effective April 4, 2022, providers will report new place of service (POS) code 10 when patients with Medicare are in their home while receiving telehealth services. CMS will also revise its existing description of POS 02. Be sure to note these changes so you can proactively avoid denials and ensure revenue integrity. 

Does your practice strive to capture Z codes? If not, what are you waiting for?

One recent report found that Z code capture rates for social determinants of health are on the rise but still remain relatively low. Yet these codes are critical for addressing population health management and improving health outcomes. What are the most commonly-reported codes? Here’s a list of the top five:

  • 0 (homelessness)
  • 4 (disappearance and death of family member)
  • 2 (problems related to living alone)
  • 3 (problems related to living in a residential institution)
  • 0 (problems in relationship with spouse or partner)

What is your practice doing to capture these codes and use the information for actionable insights to improve population health?

AMA releases new provisional CPT codes for Pfizer’s pediatric COVID-19 vaccine. Familiarize yourself with the latest.

There are three new Category 1 codes to report the Pfizer COVID-19 vaccine and immunization administration for the pediatric population, ages 5 through 11. These codes (i.e., 91307, 0071A, and 0072A), will be effective upon receiving Emergency Use Authorization or FDA approval. Be sure to bookmark and reference the AMA’s Website to monitor these and other code changes as they occur.

New and revised ICD-10-CM codes, guidelines took effect October 1. Have you made the updates internally?

There may be fewer new ICD-10-CM codes than usual this year, but that doesn’t negate their importance. In addition, there are updated guidelines as well. Among the more notable changes? New codes for COVID-19-related conditions, treatment, and testing; expanded codes to describe a cough; and several new codes to describe adverse effects, underdosing, and poisoning related to cannabis and synthetic cannabinoids. Be sure to review these changes and report the most specific and accurate diagnosis code at all times.

Seniors may need help using telehealth. Is your practice prepared to offer it?

Although many seniors are capable of using telehealth, others may need a little help. Medical practices intending to expand telehealth efforts must identify ways to engage this population. One Rhode Island-based Accountable Care Organization (ACO) has figured out to how provide this assistance. In particular, the ACO received a grant from the Rhode Island Foundation to partner with two local resources to provide mHealth-enabled tablets and a bilingual community health worker to help seniors learn how to use telehealth. The community health workers also assist these patients with connecting the technology during the visit. Are any similar grants available in your area? What else can your practice to do improve access and address social determinants of health?

About us

Physician Practice Resources, Inc., founded in 2002 and headquartered in Midlothian, IL, is a full-service company that partners with small and large healthcare organizations to build solutions that enhance operational effectiveness, improve clinical documentation, and decrease overall compliance related risks. Contact us at https://www.ppr-corp.com/about-ppr-corp/ for more information.

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