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Blog | In Record Time, Inc. | 1-800-788-4960

 COVID-19 has brought with it a whole host of operational and financial changes with which hospitals are grappling. Take a few minutes to read these newsworthy developments that may help your organization navigate COVID-19 while continuing to provide patients with high-quality care. Wishing you, your families, and your colleagues health and wellness in the months ahead.


Note new guidance for coding, billing COVID-19

As COVID-19 cases continue to rise, coders must be prepared to capture cases using new CPT and ICD-10-CM codes. Here’s what you need to know:


  1. Report CPT code 87635 for COVID-19 testing, and be sure to review the American Medical Association’s (AMA) guidance published in CPT Assistant on how to report this code.

  2. Report new ICD-10-CM code U07.1 for COVID-19. MS-DRG grouper software has been updated to reflect this new code.

  3. The AMA has provided helpful advice, including 11 coding scenarios, that can help coders maintain compliance when reporting COVID-19-related services.

  4. Note that COVID-related services, including testing, isolation/quarantine, and vaccination, are generally covered as Essential Health Benefits under Medicare, and many private payers are following suit.


    Increased patient volumes raise HIM questions, concerns

    A new report finds that hospital readiness for COVID-19 varies significantly nationwide and that many hospitals are unprepared for a potential influx of patients. Authors of the report cite several recommendations to increase surge capacity such as canceling elective surgeries; using halls, conference rooms, and amphitheaters to increase physical capacity; speeding the discharge of patients well enough to leave, and more. However increased staffing shortages add a layer of complexity. The situation has become so dire that President Trump recently deployed Navy hospital ships to coronavirus hot zones.


    All of these developments raise questions about the overall impact on HIM departments nationwide. Are managers prepared to prioritize cases and audits? Are they ready to move all staff offsite? How might they handle unexpected absences due to positive tests or quarantines? Are they connected with a coding vendor that can provide back-up support? These are just a few of the questions managers should be asking.


    CMS loosens telehealth requirements during COVID-19 crisis

    Per new CMS guidance, effective March 6, 2020, Medicare will pay for office, hospital, and other visits furnished via telehealth across the country and including in a patient’s place of residence. However, providers must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient. Important to note: The Office for Civil Rights will waive penalties for HIPAA violations against providers using FaceTime or Skype. Be sure coders understand these changes—and that they know when to report telehealth versus and virtual check-ins and e-visits.


    Office of the National Coordinator publishes 21st Century Cures Act Final Rule

    Patients will soon have free and secure access to their data, according to the 21st Century Cures Act Final Rule that requires providers to open their EHR systems through standardized application programming interfaces. The rule requires providers to share all electronic health data within 24 months, though some experts argue the timeline should be expedited in light of COVID-19. Is your organization prepared for these new requirements? And more importantly, does your organization promote documentation and coding integrity, both of which will be paramount as patients access their data?


    New cancer registry collects data on cancer patients with COVID-19

    The CCC19 Registry is a multi-institutional collaborative effort to collect data on patients with cancer suspected or confirmed as having COVID-19. Twenty-five cancer institutions have already begun participating in answering survey questions that collect data on demographic information, COVID-19 diagnosis and course of illness, cancer diagnosis and treatment details, and information about the healthcare professional. Principle investigator Jeremy L. Warner, MD, MS encourages all providers to participate.


    For more information about these developments, contact In Record Time at 800-788-4960.




February brings a whole host of newsworthy developments: New codes for coronavirus (COVID-19) and vaping-related disorders, sepsis hospitalizations on the rise, and more. Check out these five stories that should be on your radar this month:


Z codes help providers capture social determinants of health (SDOH)

The use of Z codes for SDOH is on the rise, according to a new CMS report. Between 2016 and 2017, the unique beneficiary count for Z codes increased by 4.69%. The top five    most utilized Z codes for Medicare FFS beneficiaries in 2017 are as follows:


  1. Z59.0: Homelessness

  2. Z60.2: Problems related to living alone

  3. Z63.4: Disappearance and death of family member

  4. Z65.8: Other specified problems related to psychosocial circumstances

  5. Z63.0: Problems in relationship with spouse or partner


    The CMS report also provides the top 10 chronic conditions, age distribution, sex distribution and more among Medicare beneficiaries with Z codes in 2017. 


    A recent study published in Health Affairs indicates that hospitals are focusing most frequently on interventions related to housing, employment, and food security. Coded data is critical to ensure that these interventions are successful. Does your organization report Z codes so it can move the needle on SDOH and value-based care?


    CDC issues interim coding guidance for coronavirus (COVID-19)

    New interim coding guidance for healthcare encounters and deaths related to 2019 novel coronavirus (COVID-19) provides information on how to code the following scenarios:


  • Acute bronchitis confirmed as due to COVID-19

  • Acute respiratory distress syndrome due to COVID-19

  • Bronchitis not otherwise specified (NOS) due to the COVID-19

  • Confirmed exposure to COVID-19

  • COVID-19 associated with lower respiratory infection NOS or acute respiratory infection NOS

  • COVID-19 associated with respiratory infection NOS

  • Pneumonia confirmed as due to COVID-19

  • Possible exposure to COVID-19 that’s ruled out after evaluation

  • Suspected, possible, or probable COVID-19


    CMS also issued a new code for coronavirus lab test. As of April 1, 2020, the Medicare claims processing system will accept new HCPCS code U0001 for dates of service on or after February 4, 2020. Is your organization capturing all of these codes correctly?


    Cancer registry data drives 2019 State of Lung Cancer report

    The American Lung Association used data from the North American Association of Central Cancer Registries to create its most recent State of Lung Cancer report. The report found a five-year lung cancer survival rate of 21.7 percent nationally, ranging from 26.4 percent in Connecticut to 16.8 percent in Alabama. This is up from 17.2% a decade ago. Registry data is critical in terms of helping the American Lung Association and other organizations understand cancer rates and prevention.


    CDC and NCHS implement a new diagnosis code for vaping-related disorders

    Effective April 1, 2020, hospitals can report ICD-10-CM diagnosis code U07.0 for vaping-related disorders. View the ICD-10-CM FY 2020 April Addenda to learn more about this code. Be sure to prepare physicians for documentation requirements, and work with coders to capture this new code that will help the CDC investigate the outbreak of vaping-associated lung injuries. 


    Sepsis hospitalizations, costs are on the rise

    The dollar amount is staggering: Sepsis hospitalizations cost Medicare more than $40 billion in 2018, according to a recent study published in Critical Care Medicine. The study found a year-over-year increase in the total number of sepsis deaths and a year-over-year increase in the total cost of sepsis care independent of coding. More specifically, authors state the following: “Although the rise in the use of explicit diagnosis codes might reflect increasing patient and provider awareness of sepsis and possibly financial incentives to use those codes, the observed steady rise in the severest sepsis diagnoses with objective findings (such as septic shock) suggests that sepsis in fact may be becoming more common as opposed to more commonly coded.” Does your organization use coded data as a foundation for better understanding this high-cost diagnosis?


    For more information about these developments, contact In Record Time at 800-788-4960.



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