New U.S. CPT codes for COVID-19

On September 8, the AMA CPT Editorial Panel published an update to the Current Procedural Terminology (CPT®) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic

The first code, CPT code 99072, was approved in response to sweeping measures adopted by medical practices and health care organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high-quality care during in-person interactions with health care professionals. The additional supplies, materials and clinical staff time identified in this code are for items intended to mitigate the transmission of the respiratory disease for which the PHE was declared. The new code is to be reported only once per in-person patient encounter per day regardless of the number of services rendered at that encounter, allowing for the provision of extra precautions to ensure the safety of patients as well as health care professionals.

The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SAR-CoV-2 antibodies provided by laboratory tests reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection.

For quick reference, the two new Category I CPT codes and long descriptors are:

  • 99072: Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.
  • 86413: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative

Please note CMS (or other payers) have not indicated they will cover these codes. ASE will monitor this very closely and update you on any developments

ASE Supports Healthcare Workers’ Mental Health in Next Coronavirus Aid Package

Earlier this month, ASE was contacted by U.S. Congressman Raja Krishnamoorthi’s office requesting support for providing mental health resources for frontline healthcare workers during the coronavirus pandemic and beyond. Healthcare workers are making enormous sacrifices every day to defeat this virus and ensuring access to the mental health resources needed is imperative. A bipartisan letter was sent to House leadership calling for the inclusion of enhanced mental health resources for healthcare workers in the next coronavirus aid package. ASE proudly supported this request that includes the establishment of a Department of Health and Human Services grant program to allow healthcare employers and facilities to confidentially assess and treat the mental health of frontline workers in addition to ordering a comprehensive study on healthcare workers’ mental health. This letter was signed by over 90 members of Congress and is supported by over 50 organizations. Read more here. ASE’s lobbyists are monitoring this bill, and we will report further developments as they arise.

 

New CMS Changes Just Issued – Parity in Payment for Telephone Services

Updated CMS Guidance Provides Parity in Payment for Telephone Services

Today, CMS announced that it will provide parity in payment for telephone services. Specifically, Medicare payment for the telephone evaluation and management visits would be equivalent to Medicare payment for office/outpatient visits with established patients retroactive to March 1, 2020. This would increase payments for these services from a range of about $14-$41 to about $46-$110.

ASE applauds CMS’s efforts to continue to provide more support for providers in the fight against COVID-19. This change in policy had been a priority for ASE and the Alliance of Specialty Medicine. Recently, as part of the Alliance, we sent CMS a letter highlighting the need for this change to support physician practices as they seek to deliver medically necessary care under unprecedented conditions.

The guidance updated today provides temporary regulatory waivers and new rules to maximum the flexibility in the response to COVID-19.

Telephone Evaluation, Management/Assessment and Management Services, and Behavioral Health and Education Services

  • A broad range of clinicians, including physicians, can now provide certain services by telephone to their patients.
  • Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established* patients effective March 1, 2020.
  • When clinicians are furnishing an evaluation and management (E/M) service that would otherwise be reported as an in-person or telehealth visit, using audio-only technology, practitioners may bill using these telephone E/M codes provided that it is appropriate to furnish the service using audio-only technology and all of the required elements in the applicable telephone E/M code (99441-99443) description are met.
  • Using new waiver authority, CMS is also allowing many behavioral health and education services to be furnished via telehealth using audio-only communications.

Click here for the full list of telehealth services notes which services are eligible to be furnished via audio-only technology, including the telephone evaluation and management visits.

 *ASE is seeking clarification from CMS if this change includes new patients

Free ASE Coding Webinar

ASE is committed to making sure you have the resources need to thrive in today’s healthcare environment. Click here to access this FREE webinar,  2020 Reimbursement Updates Including the New Strain Code +93356. It is only 30 minutes long and focuses on the latest HOPPS and Physician Fee Schedule (PFS) changes to echo reimbursement and will help you prevent the most common errors in echo coding. A specific focus will be given to the new Myocardial Strain Imaging, CPT Code +93356.

Please feel free to share this with your colleagues and administrative staff.

Reimbursement Updates Including the New Strain Code +93356

Submission for MIPS 2019 Now Open and Check on Your 2020 Eligibility

CMS recently announced that the MIPS 2019 Data Submission Period is now open. MIPS eligible clinicians can start submitting data for 2019 through March 31, 2020. Also, you can now use the updated CMS Quality Payment Program Participation Status Lookup Tool to check on your initial 2020 eligibility for the Merit-based Incentive Payment System (MIPS). For more detailed information please click here. Interested in learning how ASE’s ImageGuideEcho™ Registry can help with future MIPS submissions? Contact Info@ImageGuideEcho.org for more information or to request a demonstration.

Myocardial Strain Imaging Add-on CPT Code and Live Webinar

ASE is proud to see the establishment of Current Procedural Terminology (CPT) add-on code +93356® to report myocardial strain imaging in conjunction with various transthoracic echocardiography procedures. The successful CPT application was a collaboration between ASE and the American College of Cardiology and will be effective for Medicare claims beginning today, January 1, 2020. This is the first new echo technology to achieve CPT editorial panel category 1 status in a decade! 

The code is intended to report myocardial strain imaging in conjunction with various transthoracic echocardiography procedures 93303, 93304, 93306, and 93308 in addition to stress echocardiography services 93350 and 93351. Additionally, the intent is for this code to be reported once per imaging session. Additional information on this code can be found on ASE’s Advocacy website.

Want to learn more? Join us for a live webinar on the 2020 Reimbursement Updates including the New Strain Code +93356, Friday, January 10, at 10:00 AM Eastern Time. The webinar will be presented by Michael Main, MD, FASE, ASE Advocacy Chair and RUC and CPT Advisor, and Denise Garris, ASE’s regulatory consultant and an expert in health policy and reimbursement.

This educational webinar will focus on the latest HOPPS and physician fee schedule (PFS) changes to echo reimbursement and help you prevent the most common errors in echo coding. Specific focus will be given to the new Myocardial Strain Imaging, CPT Code +93356. ASE would like to help the entire cardiovascular community, so this webinar is free for everyone. Please encourage your administrative and billing personnel to participate.  Register now to save your space. Specific questions regarding webinar registration can be sent to Jenn Goss at  JGoss@ASEcho.org.

ASE Is Here To Help You With Your Coding Questions

ASE is committed to providing our members with the tools and resources needed to ensure they are coding accurately, maintaining compliance with all requirements, and maximizing appropriate revenues.

Click here to see the most frequently asked coding questions. The 2019 ASE Coding Newsletter is now available. ASE also retains a coding expert that you may link to on-demand, directly through the Coding and Reimbursement page, available from both the Advocacy and Practice Management web pages.

Watch ASE’s Value of Echo Summit

ASE’s Value of Echo Summit took place during the ASE 2018 Scientific Sessions. Here are two recordings from this event: The Quality Echo Lab and Transitioning from Fee for Service to Value-Based Reimbursement. The summit focuses on key strategies and real-world solutions to ensure a high performing echocardiography lab, while also providing comprehensive insight into the ever-changing U.S. healthcare system.

ASE Retains AMA’s HOD Status

ASE is proud to announce that the Society has successfully met all the requirements needed to maintain its seat in the American Medical Association (AMA) House of Delegates.

As a member of the House of Delegates ASE:

  • Helps sets the legislative and regulatory priorities for the AMA.
  • Has full delegate status which provides ASE with full representation before CPT/RUC.
    • This delegate role has contributed to some of ASE’s more recent, substantial advocacy successes.

This is a critical piece that allows ASE to work to protect echocardiography and provide your patients with access to necessary care.

For more detailed information, please read: The ABC’s of Payment for Cardiovascular Ultrasound Services and Why the AMA Matters.

ASE will continue to ensure your voice is heard on issues related to legislative matters, regulatory issues, coding, and reimbursement.

Thank you for joining the ASE and the AMA and making sure echo continues to have a strong voice!

ASE 2018 Coding Newsletter Available

Coding accurately for the services you provide is essential, especially in today’s environment of declining reimbursement and increased scrutiny. ASE is committed to ensuring you are fairly reimbursed for your work. Reporting the most appropriate CPT® code is essential in the correct reporting of services to obtain fair and reasonable reimbursement for procedures, tests, and visits. To ensure accurate billing, ASE has developed the 2018 ASE Coding Newsletter that is now available.