One of the most common reasons for a claim to get rejected or a clinic to not get fully reimbursed is due to incorrect coding. The healthcare industry is constantly changing, and its regulations on billing are no different. It’s important for billers to stay on top of those changes to ensure their clinics get a full reimbursement for their services.
In early September 2021, the 2022 medical billing code changes were released. One of the main focuses was on streamlining codes related to COVID-19 vaccines as they continue to be administered in large quantities and especially since the booster has begun to be available to the general public. For better efficiency, there will be 15 vaccine-specific codes available to use so providers can better track and be properly reimbursed by either an insurance or the government. Since the vaccines have been declared a free healthcare service, it’s important for the providers to accurately fill out the claims and deal with any issues promptly.
As a result, the American Medical Association, according to their President Gerald E. Harmon, M.D., has improved the coding so it “correla[tes] each coronavirus vaccine and dosing schedule with its own unique CPT code has provided necessary analytical advantages to help track, allocate and optimize resources for immunization programs across the United States.” The 2022 code release will also include an appendix that should help with locating the correct code for billers to use. Either way, they should be prepared to learn this new information come the new year.
Additionally, the AMA reports that there will be 249 new codes, 63 deletions, and 93 revisions in the overall 2022 code set. Telehealth has also become a larger need since the pandemic, so expect many changes or additions to that coding. These edits revolve around the time spent on the appointment, what is discussed during it, the type of appointment, and whether or not location or accessibility affects a patients’ ability to find care (i.e. a rural patient seeking care for a medical specialty not available near them). Our coding experts will be paying close attention to the changes coming out and will adjust coding recommendations as needed so our clients continue to receive full reimbursement for services.
If you’re following these industry changes and still having issues with your billing, then it may be time to evaluate your billing team’s efficiency vs. outsourcing to experts. Outsource Receivables Inc. would be proud to partner with your specialty clinic and help improve your overall revenue cycle.