Month: January 2022
ICD-10 Adds Z Codes
Starting April 1, 2022
You will have new ICD-10-CM Z codes to report if you find the patient you are treating is partially vaccinated or unvaccinated for COVID-19.
- New subcategory Z28.31 (Underimmunization for COVID-19 status), and under it, two new patient status codes:
- Z28.310 (Unvaccinated for COVID-19).
- Z28.311 (Partially vaccinated for COVID-19).
- Z29.39 (Other underimmunization status).
Beware of X-Ray Scam
POET has been asked by a physician to make everyone aware of X-Ray destruction scam that is re-appearing.
Please protect yourself and do your homework before doing business with anyone.
CIGNA MA Information Update from POET
POET has received a few calls regarding the Cigna MA PPO plan that came into effect January 1, 2022.
- To the left is a screen shot of one PPO product’s card. (I’m sorry it is not to pretty.)
- No PCP is required.
- Referrals are not required
- Providers are still responsible for receiving PRIOR AUTHORIZATION.
You may have noticed the Cigna MA insurance card no longer sports the “HealthSpring” Logo.
The below list are for Provider use only. Not to be distributed to Patients
HMO Customer Benefit Plans for Our Service Area
PPO Customer Benefit Plans for Our Service Area
- Cigna Preferred Medicare HMO
- H4513-061-001
- CignaTotalCare HMO D-SNP
H4513-060-001 - Cigna Fundamental Medicare HMO H4513-009-000
- Cigna Preferred Savings Medicare HMO
H4513-066-000
- Cigna True Choice Medicare PPO
H7849-038-000 - Cigna True Choice Plus Medicare PPO
H7849-062-000
MGMA Washington Connection
- COVID-19 PHE ends January 16, 2022 if HHS Secretary does not renew.
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MGMA successfully advocates for sunsetting of healthcare ETSOn Dec. 27, 2021, the Occupational Safety and Health Administration (OSHA) issued a statement on the status of its COVID-19 healthcare emergency temporary standard (ETS), confirming that it is withdrawing the ETS with the exception of the recordkeeping portions.Last August, MGMA urged OSHA to not make this standard permanent, due to it disrupting ongoing efforts of medical groups to balance the needs of patients against the imperative to protect employees. Although OSHA is letting this ETS sunset, it expressed its intentions to revisit the issue of protecting healthcare workers from COVID-19 in the future by issuing another standard. MGMA will urge the Agency to solicit input from stakeholders, such as medical groups, when developing such a standard.
- Updated member resources to navigate surprise billingOn Jan. 1, 2022, the No Surprises Act requirements prohibiting certain out-of-network balance billing and new uninsured (or self-pay) good faith estimate price transparency requirements took effect. Throughout 2021, the Biden Administration released several rules implementing these newly effective requirements. The Administration will continue to release additional rules throughout 2022 outlining the remaining patient protections that have not yet been implemented.The MGMA Government Affairs team has updated member-exclusive resources to help group practices better understand the requirements in place. Check out the most up-to-date resources on the MGMA Surprise Billing landing page.
- MIPS 2021 data submission window openClinicians can now submit and review data for the 2021 performance year for the Merit-based Incentive Payment System (MIPS). The data submission window closes on March 31, 2022 at 8 p.m. (ET). The Centers for Medicare and Medicaid Services provided several flexibilities for clinicians due to the COVID-19 public health emergency, including applying an automatic reweighting of performance scores for individual clinicians.
In other MIPS updates: on Jan 1. 2022, the 2022 payment adjustment, based on clinician 2020 MIPS performance scores took effect and will be applied to Part B covered services. Additionally, looking ahead to the 2022 performance year, clinicians can now review their preliminary MIPS eligibility by signing into the Quality Payment Program website.
Have You Paid Your Fee for PMP?
If you haven’t paid your fees to keep your electronic health record (EHR) integrated with Texas’ prescription monitoring program (PMP), the state’s PMP vendor may have deactivated your connection, in which case you’ll need to pay to reactivate it.
POET Is Seeing a Trend
Please contact POET if you are experiencing a similar problem. (936) 637-7638
POET has received a few calls this week from Specialists (SCP) stating that Primary Care Physicians (PCP) have not been able to get the SCP a referral. The PCP office is stating Cigna MA is showing the SCP out of network.
- POET has been in contact with Cigna MA regarding the situation. Cigna will be reviewing to see if there is a greater problem.
- So far it appears to only be effecting SCPs in the HMO product.
- Just a reminder: SCPs do not need a referral due to the Public Health Emergency (PHE). The PHE is scheduled to lapse on January 16, 2022. POET has been on the Public Health Emergency website and the U.S. Department of Health & Human Services website to look for new information on the PHE lapse date. We have nothing to report as of this post.
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