February/March 2020

Minnesota AUC Newsletter

February/March 2020

Coronavirus (COVID-19) Updates

For detailed information regarding the Coronavirus (COVID-19) outbreak and community mitigation strategies, go the Minnesota Department of Health website and the federal Centers for Disease Control website.

Billing and coding for COVID-19:

  • March 13, 2020: As recently announced in a "CPT Assistant Special Edition" - "The American Medical Association Current Procedural Terminology (CPT®) Editorial Panel convened a special meeting and approved a new, specific CPT code [87635] -- to describe laboratory testing for severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2). Note: Per the World Health Organization, the official name of the virus is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while the name of the disease it causes is coronavirus disease (COVID-19)."

    Per the CPT Editorial Panel, "Code 87635 is effective immediately for use in reporting this testing service. Note that code 87635 is not in the CPT 2020 publication; however, it will be included in the CPT 2021 code set in the Microbiology subsection of the Pathology and Laboratory section."

    For more information, see "CPT® releases new coronavirus (COVID-19) code & description for testing."

  • March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs.

    For more information, see the related CMS press release.

  • February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19. For more information, see the related CMS press release.

HHS issues final rules to implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act (Cures Act)

On March 9, 2020 the federal Department of Health and Human Services (HHS) issued two rules to implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act (Cures Act). According to HHS, the two rules "mark the most extensive health care data sharing policies the federal government has implemented, requiring both public and private entities to share health information between patients and other parties, while keeping that information private and secure."

The rules were developed by the HHS Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid (CMS). Among other provisions, the CMS Interoperability and Patient Access final rule "requires health plans in Medicare Advantage, Medicaid, CHIP, and through the federal Exchanges to share claims data electronically with patients. Beginning January 1, 2021, Medicare Advantage, Medicaid, CHIP, and, for plan years beginning on or after January 1, 2021, plans on the federal Exchanges will be required to share claims and other health information with patients in a safe, secure, understandable, user-friendly electronic format through the Patient Access API."

For more information see the CMS Interoperability and Patient Access Fact Sheet and ONC’s "Cures Act Final Rule: Interoperability-Focused Policies that Empower Patients and Support Providers."

CMS Fact Sheets on HIPAA Administrative Simplification transactions and code sets

The Centers for Medicare & Medicaid Services (CMS) has created a series of fact sheets explaining the basics of HIPAA Administrative Simplification transactions and code sets. These fact sheets are designed to help the health care industry understand the purpose of HIPAA adopted transactions and to explain which standards and operating rules govern each transaction.

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Updated Tuesday, 14-Apr-2020 16:24:06 CDT