Did you know how many medical coding changes take place each year? You can expect for the next year too! For January, 2021, healthcare professionals must be ready for medical coding changes right from CPT codes in telehealth to ICD-10-CM codes for Covid-19. Everyone is eagerly waiting for Covid vaccine and as soon as it comes into play, it surely will have more impact than ever before.
In 2021, many changes are being implemented in order to expand and improve descriptors those impact the revenue payments for treatment and care of Covid-19. Adding to it, Medicare Physician Fee Schedule comes into force in 2021 which significantly impacts healthcare professionals’ reimbursement rates.
ICD-10-PCS (inpatient) Medical Coding Changes for Covid-19:
- From beginning of the year 2021,the Centers for Medicare and Medicaid Services (CMS) is ready to implement brand new ICD-10-PCS codes for covid-19 vaccines and therapeutics that includes FDA approved Baricitinib and which is at present used for rheumatoid arthritis.
- Medical coding for inpatient treatment and in conjunction with remdesivir, monoclonal antibody and immunomodulator treatments also takes place. These codes are given below:
- XW013H6: This code is used for the introduction of other new technology monocmonoclonal antibody into subcutaneous tissue and percutaneous approach, under new technology group 6.
- XW013K6: This code is used for the introduction of Leronlimab monoclonal antibody with subcutaneous tissue and percutaneous approach, under new technology group 6.
- XW013S6: This code is used for the introduction of Covid-19 vaccine dose-1 into subcutaneous tissue and percutaneous approach, under new technology group 6.
- XW013T6: This code is used for the introduction of Covid-19 vaccine dose-2 into subcutaneous tissue and percutaneous approach, under new technology group 6.
- XW013U6: This code is used for the introduction of Covid-19 vaccine into subcutaneous tissue and percutaneous approach, under new technology group 6.
- XW023S6: This code is used for the introduction of Covid-19 vaccine dose-1 into muscle, percutaneous approach, under new technology group 6.
- XW023T6: This code is used for the introduction of Covid-19 vaccine dose-2 into muscle, percutaneous approach, under new technology group 6.
- XW023U6: This code is used for the introduction of Covid-19 vaccine muscle, percutaneous approach, under new technology group 6.
- XW033E6: This code is used for the introduction of etesevimab monoclonal antibody into Peripheral vein, percutaneous approach, under new technology group 6.
- XW033F6: This code is used for the introduction of bamlanivimab monoclonal antibody into Peripheral vein, percutaneous approach, under new technology group 6.
- XW033G6: This code is used for the introduction of REGN-COV2 monoclonal antibody into Peripheral vein, percutaneous approach, under new technology group 6.
- XW033H6: This code is used for the introduction of other new technology monoclonal antibody into Peripheral vein, percutaneous approach, under new technology group 6.
- XW033L6: This code is used for the introduction of CD24Fc immunomodulator into Peripheral vein, percutaneous approach, under new technology group 6.
- XW043E6: This code is used for the introduction of etesevimab monoclonal antibody into Central vein, percutaneous approach, under new technology group 6.
- XW043F6: This code is used for the introduction of bamlanivimab monoclonal antibody into Central vein, percutaneous approach, under new technology group 6.
- XW043G6: This code is uses for the introduction of REGN-COV2 monoclonal antibody into Central vein, percutaneous approach, under new technology group 6.
- XW043H6: This code is used for the introduction of other new technology monoclonal antibody into Central vein, percutaneous approach, under new technology group 6.
- XW043L6: This code is used for the introduction of CD24Fc immunomodulator into Central vein, percutaneous approach, under new technology group 6.
- XW07M6: This code is used for the introduction of baricitinib into lower GI, through natural or artificial opening, under new technology group 6.
- XW0DXM6: This code is used for the introduction of baricitinib into mouth and pharynx, external approach, under new technology group 6.
- XW0G7M6: This code is used for the introduction of baricitinib into upper GI, through natural or artificial opening, under new technology group 6.
ICD-10-PCS Medical Coding changes for MS-DRGs:
- In Medical coding changes 2021,additional approach continued by CMS which has assigned Medicare Severity Diagnosis related groups to six ICD-10-PCS medical coding in regards to Covid-19 includes:
- 16: Personal history of Covid-19
- 52: Encounter for Covid-19 screening
- 822: Suspected exposure to Covid-19
- 82: Pneumonia caused due to Covid-19 and includes the inclusion terms “pneumonia due to COVID-19” and “pneumonia due to severe acute respiratory syndrome coronavirus 2”.
- 81: Multisystem inflammatory syndrome
- 89: Other involvement of connective tissue.
Additionally, Center for Medicare and Medicaid Services has approved the usage of CPT codes for vaccines and vaccine administration including all the inpatients. Medicare Advantage participants should submit original claims to Medicare for all the vaccines and vaccine administration in 2021.
Telemedicine is a must for 2021:
- Telemedicine or telehealth became very effective during the times when coronavirus started spreading across the world.
- Medical coding changes for Covid-19 are going to take place with all the newly adopted norms and regulations .
- Virtual care platforms such as video conferencing and digital monitoring have been tremendously used to control the spread of Covid-19.
- As there’s a need for innovation and requirements for telemedicine services in the upcoming years, medical solutions such as telehealth or telemedicine will become the focal points of new technology upgrades and software development.
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