HCCIntelligence™ Webinar Recording: What You Should Know About 2020 Coding Updates

Webinar Q and A

Pdf Summary

The document elaborates on important updates to the Medical Coding for 2020, specifically focusing on Palliative Care Management (PCM), Chronic Care Management (CCM), billing processes, and quality care tracking. <br /><br />1. PCM and CCM Billing: <br />- CMS allows primary care providers to bill CCM even when a palliative care provider bills for PCM, expecting proper communication to prevent fragmented care. However, PCM cannot be concurrently billed with other care management services like CCM, behavioral health services, or ESRD by the same practitioner for the same patient. PCM caters to patients with a high-risk complex disease needing focused management.<br /><br />2. CCM Plan Details:<br />- CCM applies to patients with two or more chronic diseases and requires individualized disease-specific treatment plans. Elements of a comprehensive care plan, as outlined by CMS, include problem lists, expected outcomes, treatment goals, assessments, interventions, medical and environmental management, caregiver assessments, and coordination of services.<br /><br />3. Quality Metrics and Home Visits:<br />- Metrics for homebound patients cover various health indicators, such as blood pressure control, vaccination status, and depression screening. Medical necessity for home visits must be documented to justify the care provided. Previously required additional justification for home visits has been relaxed but practices should still document personalized visit frequencies.<br /><br />4. High Complexity Billing:<br />- High complexity billing within seven days of discharge necessitates both timely visits and meeting high medical decision-making (MDM) criteria. MDM involves the number of diagnoses, the complexity of data reviewed, and overall risk assessment. Proper documentation supports this process.<br /><br />5. Prolonged Services Billing:<br />- Dr. Chiang utilizes prolonged service billing (CPT 99358) with updated templates for documentation. This includes start and stop times, review of extensive patient records, and logs of previous diagnostics.<br /><br />6. Startup and Telemedicine Codes:<br />- Utilize specific home visit and domiciliary codes along with identifying care management and remote patient monitoring opportunities. Efficiency can be enhanced with personalized EHR templates and technologies.<br /><br />7. EPIC Scheduling:<br />- While EPIC supports the development of home-based primary care modules, there are no plans for integrated scheduling. Resources for geographic scheduling in home care can be found in HCCIntelligence webinars.

Keywords

Medical Coding 2020

Palliative Care Management

Chronic Care Management

Billing Processes

Quality Care Tracking

High Complexity Billing

Prolonged Services Billing

Home Visits

Telemedicine Codes

EPIC Scheduling