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Updates

CMS's second COVID-19 interim final rule further relaxes Medicare regulations

CMS will allow the home to be considered a provider-based department during the pandemic, meaning hospitals can be paid a facility fee when hospital-based physicians or clinicians deliver care to patients in their homes.

https://www.hfma.org/topics/coronavirus/cms-s-second-covid-19-interim-final-rule-further-relaxes-medicar.html

CARES Funding Details, COVID-19 Policy Revisions

As providers were scheduled to begin receiving CARES funding on April 10, HFMA released a summary of the associated details:

https://www.hfma.org/topics/news/2020/04/details-released-on-how-much-each-provider-will-receive-from--30.html

HFMA's executive summary of policy and regulatory revisions in response to the COVID-19 emergency:

https://www.hfma.org/industry-initiatives/regulatory-and-accounting-resources/fact-sheets/medicare-medicaid-programs-policy-regulatory-revisions-covid19-response.html

CMS Announces Expanded Advance Payment Program

On Saturday 3/28/2020, the Centers for Medicare & Medicaid Services (CMS) announced nationwide expansion of the existing accelerated Advance Payment Program (APP), making the program available for most Medicare physicians and group practices. The APP provides a quick mechanism for healthcare entities to obtain accelerated, interest-free cash flow. For a detailed guide, see:

https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf

Did you know Aetna covers two way synchronous telehealth visits, using GT and 95 modifiers?

These visits are reimbursed at the same rate as in person visits. Beginning March 6th, 2020, Aetna started offering zero co-pay telemedicine visits for any reason for 90 days. Cost share will be waived for all video visits through the Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care for all Commercial plan designs. HCPCS G2010 and G2012 will also be covered during this 90-day period. Until further notice, Aetna Medicare members will also be covered for telehealth medicine.

https://www.aetna.com/health-care-professionals/provider-education-manuals/covid-faq.html

AAFP Coding for the new coronavirus and COVID-19 illness 3/19/2020

The CDC has released Official Coding Guidance (ICD10) for reporting healthcare encounters related to the 2019 novel coronavirus (COVID-19):

- Pneumonia, confirmed as due to COVID-19 J12.89, B97.29

- Acute bronchitis, confirmed as due to COVID-19 J20.8, B97.29

- Bronchitis NOS, confirmed as due to COVID-19 J40, B97.29

- Acute/lower respiratory infection NOS, confirmed as due to COVID-19 J22, B97.29

- Respiratory infection NOS, confirmed as due to COVID-19 J98.8, B97.29

- Acute respiratory distress syndrome, confirmed as due to COVID-19 J80, B97.29

- Possible exposure to COVID-19, condition ruled-out Z03.818

- Exposure to confirmed COVID-19 Z20.828

Learn what Cigna is doing to protect customers and communities again covid-19

On March 13th, 2020, Cigna took action to adapt to the situation. They are in the process of sending out to providers their updated short-term policy telehealth billing policy. Most importantly this update includes billing guidelines outlining the use of codes U0001, U0002 and 87635 for COVID-19 testing, of ICD10 code B97.29 for treatment of confirmed cases, and of code 99241 & G2012 for virtual visits. When following their updated guidelines, COVID-19 related virtual screenings will be covered with no cost share-for the customer, and non-COVID-19 related virtual services will be covered at standard office visit rates.

https://www.cigna.com/newsroom/news-releases/2020/cigna-takes-additional-actions-to-protect-customers-and-communities-against-covid-19

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