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CMS Expands Medicare Payments for At-Home COVID-19 Vaccinations

PROVIDER RECEIVE THE INCREASED PAYMENTS UPTO 5 TIMES As part of the Biden-Harris Administration’s ongoing commitment to increasing access to vaccinations and improving health equity, CMS is expanding opportunities for people to receive COVID-19 vaccinations in their homes.  To ensure Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach can receive the vaccination, health care providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home.   This announcement aims to further boost the administration of COVID-19 vaccination – including second and third doses – in smaller group homes, assisted living facilities, and other group living situations. The allowing vaccine providers to receive the increased payment up to 5 times when fewer than 10 Medicare beneficiaries get the vaccine on the same day in the same home or communal setting. 

CMS' Amended repayment process for accelerated and advance repayments

AAP - Repayment Process CMS issued payments to providers and suppliers to help ease financial strain due to a disruption in claims submission and/or claims processing related to the COVID-19 public health emergency. The Congress amended repayment process for the accelerated and advance payments through the Continuing Appropriations Act, 2021 and Other Extensions Act: Repayment will now begin one year after the date of the issuance of the payment. During the first 11 months after repayment begins, repayment will occur through automatic recoupment of 25% of Medicare payments otherwise owed to you. During the succeeding six months, repayment will occur through an automatic recoupment of 50% of Medicare payments otherwise owed to you. If AAP payment is not completed within 29 months, t he provider will receive a demand letter requiring repayment of any outstanding balance with an i nterest rate of 4%. 

Additional New CPT codes and Payments - COVID-19 Vaccine - Effective from 08/12/2021

COVID-19 Vaccine Additional Dose - Payment Medicare stands ready to pay for administering an additional dose of COVID-19 vaccine consistent with the FDA emergency use authorization (EUA).  They will pay the same amount to administer this additional dose as we did for other doses of the COVID-19 vaccine ( approximately $40 each) .  The U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) for both the Pfizer-BioNTech COVID-19 Vaccine and the Moderna COVID-19 Vaccine to allow for the use of an additional dose in certain immunocompromised individuals, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. Additional New CPT codes - COVID-19 Vaccine - Effective from 08/12/2021 When COVID-19 vaccine and monoclonal antibody doses are provided by the government without charge, only bill for the vaccine administration. Don't include the vaccine codes on the c

Influenza Vaccines for Season 2021/2022



WHO recently already released ICD 11th edition and will come into effect on Jan 01, 2022. Let’s all not come into panic mode and note that so far the USA is not sure about when they’ll be ready to implement ICD 11 so far, but still, we cannot say anything. Let’s see the Difference between the ICD 10 and the ICD 11 Coding systems. The ICD-11 MMS is the primary derivative of the Foundation Component, and that is commonly referred to and recognized as "ICD-11 MMS. The abbreviation is variously written with or without a hyphen between 11 and MMS.  MMS stands for Mortality and Morbidity Statistics. These codes are a minimum of 4 character codes in ICD 11 and 2 levels of subcategories. The chapter numbering of ICD 11 is Arabic numbers, not Roman numbers ICD 10 represents 14400 diagnosis but ICD 11 has 55,000 unique codes to represent the comprehensive list of diagnosis. Changing the number of items in the ICD is considered extremely useful because it allows researchers and health care o

ICD 10 CM Official Updates and Changes - 2022 - Revised Codes

REVISED CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022 Code Description F32           Depressive episode G71.20 Congenital myopathy, unspecified M35.0 Sjogren syndrome M35.00 Sjogren syndrome, unspecified M35.01 Sjogren syndrome with keratoconjunctivitis M35.02 Sjogren syndrome with lung involvement M35.03 Sjogren syndrome with myopathy M35.04 Sjogren syndrome with tubulo-interstitial nephropathy M35.09 Sjogren syndrome with other organ involvement T63.61 Toxic effect of contact with Portuguese Man-o-war T63.611 Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional) T63.611A Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), initial encounter T63.611D Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), subsequent encounter T63.611S Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), sequela T63.612 Toxic effect of contact wit

ICD 10 CM Official Updates and Changes - 2022 - Deleted Codes

DELETED CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022 Code Description T40.7X Poisoning by, adverse effect of and underdosing of cannabis (derivatives) T40.7X1 Poisoning by cannabis (derivatives), accidental (unintentional) T40.7X1A Poisoning by cannabis (derivatives), accidental (unintentional), initial encounter T40.7X1D Poisoning by cannabis (derivatives), accidental (unintentional), subsequent encounter T40.7X1S Poisoning by cannabis (derivatives), accidental (unintentional), sequela T40.7X2 Poisoning by cannabis (derivatives), intentional self-harm T40.7X2A Poisoning by cannabis (derivatives), intentional self-harm, initial encounter T40.7X2D Poisoning by cannabis (derivatives), intentional self-harm, subsequent encounter T40.7X2S Poisoning by cannabis (derivatives), intentional self-harm, sequela T40.7X3 Poisoning by cannabis (derivatives), assault T40.7X3A Poisoning by cannabis (derivatives), assault, initial encounter T40.7X3D Poison