HAP Radiology Billing and Coding Blog

There are 490 new ICD-10-CM^[i] codes that became effective on October 1, 2020, all of which are replacing existing codes. An additional 47 codes have been revised and 58 were deleted. Two new codes, U07.1 for COVID-19 and U07.0 for vaping-related disorders, took effect on April 1, 2020. They are contained in a new section of the guidelines, Chapter 22 “Codes for Special Purposes (U00 – U85)”.

Radiologists practicing in an imaging center or other non-hospital facility have a new tool available that will potentially allow them to recover some of the added costs related to safety precautions taken during the COVID-19 public health emergency. CPT code 99072 was added by the American Medical Association (AMA) Current Procedural Terminology (CPT^®) Editorial Panel on September 8, 2020, with immediate effect. While payment for this code is not yet available from Medicare, it might be reimbursed by some commercial payers.

One of the fastest and easiest sources of emergency funding available to practices at the outset of the COVID-19 pandemic was the Medicare Accelerated and Advanced Payment Program.  As we recently reported, the initial timetable called for repayment of those advances to begin 120 days after the advance was made. Repayment was to be accomplished through reduction of Medicare reimbursements otherwise payable to the practice currently, until the full amount of the advance was repaid.

The average cut of 11% in radiology reimbursement that is proposed by the Medicare Physician Fee Schedule for 2021 (MPFS) is the continuation of a trend that spans more than a decade.

The Centers for Medicare and Medicaid Services (CMS) has released their annual proposal for changes to the Medicare payment system for the coming year. The Medicare Physician Fee Schedule (MPFS) Proposed Rule contains not only proposed adjustments to Medicare reimbursement but also proposed changes to the Quality Payment Program (QPP) for 2021 and beyond.

Since the end of March we all have been focused on the impact of the public health emergency created by the COVID-19 pandemic, but slowly our attention is returning to the other ongoing issues of operating a practice.  Let’s review some important topics that still exist on our radar screens.

The first article in our three-part series covered workplace safety policies, changes to your office space, and workflow processes, while the second article discussed human resources and patient scheduling considerations.  In this final article, we look at ways to strengthen the return of patient volume to your practice through community collaboration and marketing.

The first article in our three-part series covered workplace safety policies, changes to your office space, and workflow processes.  Next, we will discuss the many aspects of human resource management and address patient scheduling in this new environment. 

On June 3, 2020, Congress passed the Paycheck Protection Program Flexibility Act of 2020 (PPPFA) that modifies the Paycheck Protection Program (PPP) that was put in place as part of the Coronavirus Aid, Relief and Security (CARES) Act.  The PPP is a potentially forgivable loan administered by the Small Business Administration (SBA).  This latest legislation changes some of the terms and requirements that will lead to loan forgiveness as we outlined in our recent article. 

There are many variables to consider in addressing the uncertainties that lie ahead. While we know there is a lot of excellent information available, our hope is that we have been able to curate some relevant guidance that will help your practice thrive again in this period of uncertainty.  Areas of focus for your practice should include: