Coding and Documentation

Q: Under the introductory section of the CPT Manual’s Organ or Disease-Oriented Panels section, third paragraph, it is stated, "Do not report two or more panel codes that include any of the same constituent tests performed from the same patient collections." I am seeking clarification as to whether this literally means the same blood specimen collection or if it more generally means the same date of service (DOS) collection. In the hospital setting sometimes constituent tests are performed on the same DOS on an outpatient encounter, so it might lead one to report an applicable panel code. However, sometimes the constituents are not ordered at the same time, and the tests might be run from separate blood specimens drawn at different times, but still on the same DOS. Is there any guidance or reference that could clarify this?

CMS released the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) proposed rule May 11, which includes just shy of 600 ICD-10-CM code changes. Proposed changes include 490 code additions, 47 revisions, and 58 invalidations, slated to go into effect October 1.

CMS’ fiscal year (FY) 2021 Inpatient Prospective Payment System (IPPS) proposed rule, released May 11, proposes new price transparency requirements focused on reporting of negotiated charges.

NAHRI’s April 28 Quarterly Call featured in-depth presentations on key performance indicators (KPIs) and billing and coding for telehealth in the age of COVID-19.

NAHRI Director Jaclyn Fitzgerald, CHRI, led off the call with a handful of important announcements, including the introduction of NAHRI Advisory Board members.

CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.

Q: Should providers be documenting the time for all telehealth and telemedicine visits?

The next episode of NAHRI’s new podcast, The Revenue Integrity Show, airs Thursday, May 7, at 3 p.m. Eastern. This episode dives into the impact of COVID-19 on revenue integrity from the perspective of a physician and an operations expert.

The recording of the April 28 members-only Quarterly Conference Call is now available for streaming.