Tag: Billing
CPT code for Janssen CoVid-19 Booster
October 27, 2021
The new CPT code for the booster dose of the Janssen COVID-19 vaccine joins unique CPT codes previously issued to COVID-19 vaccine booster doses from Moderna and Pfizer.
For quick reference, the new code assigned to the Janssen booster for the COVID-19 vaccine is:
0034A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5 mL dosage; booster dose
COVID-19 FAQs on Medicare FFS Billing, CMS, October 6, 2021
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Attention: Codes deleted from ICD-10
ATTENTION!
Please Read!
Thirty-nine codes were deleted from the 2022 ICD-10 code set effective October 1, 2021.
Three of these 39 codes are billed by PCPs quite frequently:
M54.5 (low back pain)
R05 (cough)
R63.3 (feeding difficulties)
POET has been told, “Cigna Medicare is denying the whole claim as “inappropriate diagnosis code” when billed with one of these deleted codes. “
ICD-10 Codes Deleted Effective 10/1/2021
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Get the Latest Cigna Updates.
In Accurate Medicare Claim DENIALS!!
Novitas Solutions, the Medicare payer for Texas, announced that a system error has caused the improper rejection of Medicare Part B claims submitted on or after July 6. Physicians who received a claim rejection message should not resubmit claims at this time. Novitas says it is researching a claims processing system fix. TMA is monitoring the problem.
Incident-To Billing Got You Confused?
Texas Medical Association (TMA) can help!
“Incident-to” billing – when services delivered by a nonphysician practitioner are billed under a supervising physician’s credentials – can be confusing, and Texas Medical Association staff are routinely fielding questions about those unique arrangements.
To help you avoid any billing blunders, TMA has released an education sheet on incident-to billing (login required), with a basic overview of guidelines and requirements.
The two-page guide addresses incident-to billing for Medicare, Medicaid, and commercial plans, along with helpful links to resources that can help answer your questions and resolve billing snags.
Download the incident-to education sheet – along with other resources on billing, collection, claims, and more – on TMA’s Educational Quick Tips page.
From CMS.Gov
Critical Care Evaluation & Management Services: Comparative Billing Report in May
In late May, CMS will issue a second letter in the Special Edition Comparative Billing Report (CBR) series on Part B claims for critical care evaluation & management services. Use the data-driven tables to compare your billing and payment patterns with peers in your state and across the nation.
The public can’t view CBRs. Look for an email from [email protected] to access your report. Update your email address in the Provider Enrollment, Chain, and Ownership System to ensure delivery.
More Information:
- View a webinar recording
- Visit the CBR website
- Register for a live webinar on June 9 from 3-4 pm ET
COVID-19 news from UnitedHealthcare 3/30/2021
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Need Expert Advice
The Texas Medical Association is launching a new “Ask the Expert” virtual series to bring members direct access to professional experts who can answer questions on legal, practice management, advocacy, and regulatory topics.
Join them each month as a TMA staff expert hosts a virtual meeting to discuss their area of expertise and answer questions from attendees
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