Enos Medical Coding

05/10/2023

May 11 is almost here! Have you made any changes that will end with the PHE?

07/12/2022

http://www.enosmedicalcoding.com/
While we're enjoying summer, Enos Medical Coding is also looking ahead to January and the 2023 CPT changes. There will be an unprecedented number of changes to the most often reported chapter of the CPT Manual. We're ready to educate your providers and staff. Take a moment to check out my summary, and plan some education for the fall. In the meantime, Happy Summer!

ancy Enos Medical Coding

08/19/2020

Telemedicine visits are here to stay, are you documenting and billing correctly? Read our FAQ's here

Since 1975, Sansiveri has been providing audit, accounting, forensic, financial planning, valuation, tax, strategic planning, and business counsel to businesses and their management teams throughout Southeastern New England.

07/25/2020

Telemedicine has been a lifesaver for many patients who need care, but are vulnerable. Learning the documentation requirements is important, CMS may keep some telemedicine in place, but ramp up audits to be sure there are no false payments. Do you know the documentation requirements? Enos Medical Coding can help your practice with an audit to ensure you are compliant in billing telemedicine.

In response to the telehealth expansions and increased usage during the pandemic, CMS is reviewing the temporary regulation changes it made and assessing which should become permanent, according to CMS Administrator Seema Verma.

05/20/2020

Here is a sneak peak, registration is open for tomorrow's MGMA Virtual Conference.

In this episode, we’re joined by Nancy Enos, a medical coding expert who discusses billing and reimbursement challenges since the start of the COVID-19 pandemic and ways to overcome them.

05/19/2020

Don't miss Thursday's Virtual Conference. For a preview, check out this podcast on Telemedicine billing and coding.

In this episode, we’re joined by Nancy Enos, a medical coding expert who discusses billing and reimbursement challenges since the start of the COVID-19 pandemic and ways to overcome them.

04/09/2020

Medicare will pay 100% for COVID-19. Cost-sharing does not apply for COVID-19 testing-related services, which are medical visits that: are furnished between March 18, 2020 and the end of the Public Health Emergency (PHE); that result in an order for or administration of a COVID-19 test; are related to furnishing or administering such a test or to the evaluation of an individual for purposes of determining the need for such a test; and are in any of the following categories of HCPCS evaluation and management codes:

Office and other outpatient services
Hospital observation services
Emergency department services
Nursing facility services
Domiciliary, rest home, or custodial care services
Home services
Online digital evaluation and management services
Cost-sharing does not apply to the above medical visit services for which payment is made to:

Hospital Outpatient Departments paid under the Outpatient Prospective Payment System
Physicians and other professionals under the Physician Fee Schedule
Critical Access Hospitals (CAHs)
Rural Health Clinics (RHCs)
Federally Qualified Health Centers (FQHCs)
For services furnished on March 18, 2020, and through the end of the PHE, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under these payment systems should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.

For professional claims, physicians and practitioners who did not initially submit claims with the CS modifier must notify their Medicare Administrative Contractor (MAC) and request to resubmit applicable claims with dates of service on or after 3/18/2020 with the CS modifier to get 100% payment.

For institutional claims, providers, including hospitals, CAHs, RHCs, and FQHCs, who did not initially submit claims with the CS modifier must resubmit applicable claims submitted on or after 3/18/2020, with the CS modifier to visit lines to get 100% payment.

04/03/2020

New ICD-10-CM diagnosis code, U07.1, for COVID-19
In response to the national emergency that was declared concerning the COVID-19 outbreak, a new diagnosis code, U07.1, COVID-19, has been implemented, effective April 1, 2020.

04/03/2020

4/3/2020 Friday Special Medicare Update: Billing for Professional Telehealth Distant Site Services During the Public Health Emergency — Revised
This corrects a prior message that appeared in our March 31, 2020 Special Edition.
Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:
• Place of Service (POS) equal to what it would have been had the service been furnished in-person
• Modifier 95, indicating that the service rendered was actually performed via telehealth