From a compliance exposure perspective, we believe that the HIPAA risk associated with sending PHI abroad is simply untenable. HIPAA is an American law that does not extend beyond our borders. The only way to ensure HIPAA protection abroad is to do so contractually via a BAA.  There is no regulatory authority abroad for the...

A lot of information is appearing very fast about COVID-19 (coronavirus disease 2019), and medical coders have the extra challenge of sorting through the onslaught to find the bits relevant to coding claims related to testing and treatment. This Q&A brings together the latest authoritative news about coding for COVID-19.

Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to amend the methodology and other requirements for the U.S. Department of Health and Human Services’ risk adjustment data validation (HHS-RADV) program. HHS-RADV was created to strengthen the...

Some doctors don’t understand how coders compliantly select codes. This can set up coding-clinical disconnects. Frankly, I don’t always get it myself, and I’m pretty good at this coding thing.

While the introduction of new COVID-19 reimbursement rules and regulations have brought on their share of confusion, there is one certainty healthcare organizations can bank on: oversight of incentive dollars will be a regulatory priority. In fact, federal watchdogs are not wasting any time, as reports...

Faced with the unique circumstances under COVID-19, many skilled facilities are wondering how to make ends meet.  First things first: proper infection control procedures, getting proper personal protective equipment (PPE), and limiting the infiltration of COVID-19 into your...

The Centers for Medicare and Medicaid Services (CMS) released the final FY21 ICD-10-PCS codes on May 28, 2020 which was earlier than expected.  The table below will show the changes between Final FY20, Proposed FY21, and Final FY21:

A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers across multiple states. That's why revenue cycle leaders from Privia...

CMS’ announcement of telehealth reimbursement payment parity is a huge win for our community. After weeks of active engagement to CMS, Congress and the administration, CMS announced that it will reimburse audio-only E/M telehealth visits at the same rate as...