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​The Party's Over – Audits are Back!

10/26/2020

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The federally declared public health emergency (PHE), set to expire on October 23, was renewed and will remain due to the continued impact of the COVID-19 pandemic. The more relaxed regulatory rules regarding Medicare and Medicaid compliance associated with the PHE is no more, as healthcare provider’s ramp up preparedness with focus on internal processes. 

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COVID-19 Testing, Claim Coding, and Submissions: Ensuring Proper Reimbursement and Compliance Check

10/2/2020

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By Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
​In the early stages of the pandemic, CMS guidance indicated that a provider's documentation was sufficient to receive reimbursement from payers. The 20‐percent higher Medicare reimbursement for inpatient COVID treatment and a positive test result was not necessary. However, effective September 1, 2020, CMS has enlisted a mandate requiring hospitals to have positive COVID‐19 laboratory tests in patients' records to qualify for Medicare's 20‐percent add‐on payment. Suffice it to say, ensuring appropriate reimbursement for COVID-19 claims require careful management and attention to detail. 

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Axea Solutions, Inc. | 5991 Parkway North Blvd, Suite A | Cumming, GA 30040 | info@axeasolutions.com | 855.424.4249
  • Home
  • Services
    • Coding Audits
    • Claims and Edit Remediation
    • Denials & Appeals Management
    • RCM Advisory
    • Coder Education and Training
    • Clinical Documentation Improvement
  • EDUCATION
  • TECHNOLOGY
  • About
    • Why Axea Solutions?
    • Leadership
    • Team
    • Axea in Action
  • News
  • Contact
  • Blog