COVID-19 Resource Center

DuxWare is committed to helping you stay up to date and aware of changes that will affect your practice. That's why: 

Our Service and Support Teams continue to function without disruption.
We are monitoring updates from CDC, CMS and commercial payers daily.
We have ongoing communication with our business partners to avoid disruption of services.
We will continue to ensure our products are equipped to handle billing and edit changes surrounding this emergency, especially as it relates to TeleHealth.
We have ensured that any needed diagnosis codes or procedure codes are present in DuxWare ready to be used as needed.

General information & updates

Coronavirus.gov

The source for the latest information about COVID-19 prevention, symptoms, and answers to common questions.

USA.gov

Get the latest information about what the U.S. Government is doing in response to COVID-19.

CDC.gov/coronavirus

Stay up to date with public health and safety information from CDC and for the overarching medical and health provider community on COVID-19.

Learn about Medicare Coverage and Payment of Virtual Services

by Medicare Learning Network

How Can We Assist?​

If there is any way we can assist you, please let us know.

News For Your Practice

CMS Builds on Commitment to Transform Healthcare Through Competition and Innovation

from cms.gov
05/11/2020
#cms

CDC updates FAQ - Clinical Questions about COVID-19

from cdc.gov
05/06/2020
#cdc

CMS has updated their FAQ to assist Medicare Providers.

from cms.gov
05/01/2020
#cms

Tips for keeping your practice in business during COVID-19

Physicians today are encountering unprecedented business challenges for their practices due to the COVID-19 pandemic. During these uncertain times, the AMA has developed free resources, including a checklist of tips to keep your practice operational and nimble.

04/27/2020
#ama

CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment Program

On April 26, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately. The agency made this announcement following the successful payment of over $100 billion to health care providers and suppliers through these programs and in light of the $175 billion recently appropriated for health care provider relief payments.

CMS had expanded these temporary loan programs to ensure providers and suppliers had the resources needed to combat the beginning stages of the 2019 Novel Coronavirus (COVID-19). Funding will continue to be available to hospitals and other health care providers on the front lines of the coronavirus response primarily from the Provider Relief Fund. The Accelerated and Advance Payment (AAP) Programs are typically used to give providers emergency funding and address cash flow issues for providers and suppliers when there is disruption in claims submission or claims processing, including during a public health emergency or Presidentially-declared disaster.

Since expanding the AAP programs on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals. For Part B suppliers, including doctors, non-physician practitioners and durable medical equipment suppliers, CMS approved almost 24,000 applications advancing $40.4 billion in payments. The AAP programs are not a grant, and providers and suppliers are typically required to pay back the funding within one year, or less, depending on provider or supplier type. Beginning today, CMS will not be accepting any new applications for the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through the Department of Health & Human Services’ (HHS) Provider Relief Fund.

Significant additional funding will continue to be available to hospitals and other health care providers through other programs. Congress appropriated $100 billion in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (PL 116-136) and $75 billion through the Paycheck Protection Program and Health Care Enhancement Act (PL 116-139) for health care providers. HHS is distributing this money through the Provider Relief Fund, and these payments do not need to be repaid.

The CARES Act Provider Relief Fund is being administered through HHS and has already released $30 billion to providers and is in the process of releasing an additional $20 billion, with more funding anticipated to be released soon. This funding will be used to support health care-related expenses or lost revenue attributable to the COVID-19 pandemic and to ensure uninsured Americans can get treatment for COVID-19.

For more information on the CARES Act Provider Relief Fund and how to apply, visit: hhs.gov/providerrelief.

For an updated fact sheet on the Accelerated and Advance Payment Programs, visit:  https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf.

04/27/2020
#cms

Free Coding for Telemedicine and COVID-19 Webinar

from ama-assn.org

Join American Medical Association for a free webinar for authoritative guidance on coding for telehealth services.  Wednesday, May 6  from Noon – 1 p.m. CST

04/24/2020
#ama

Opening Up America Again! Re-opening Facilities Phase 1

from cms.gov

Read the latest guidelines for Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare.

04/19/2020
#ama

The American Medical Association (AMA) adds news codes intended to report when patients receive blood tests that detect COVID-19 antibodies. These codes have been added to your DuxWare system.

from ama-assn.org
04/15/2020
#ama

Expanded Coverage for Diagnostic Services

from cms.gov

The Centers for Medicare & Medicaid Services (CMS), together with the Departments of Labor and the Treasury, issued guidance today to ensure Americans with private health insurance have coverage of 2019 Novel Coronavirus (COVID-19) diagnostic testing and certain other related services, including antibody testing, at no cost.

Specifically, today’s announcement implements the requirement for group health plans and group and individual health insurance to cover both diagnostic testing and certain related items and services provided during a medical visit with no cost sharing. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test. Covered COVID-19 tests include all FDA-authorized COVID-19 diagnostic tests, COVID-19 diagnostic tests that developers request authorization for on an emergency basis, and COVID-19 diagnostic tests developed in and authorized by states. It also ensures that COVID-19 antibody testing will also be covered.

04/11/2020
#medicare   #cms

Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration)

from cms.gov

Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.

04/10/2020
#Medicare   #cms   #clinicians

CMS Issues New Wave of Infection Control Guidance to Protect Patients and Healthcare Workers from COVID-19

04/08/2020
#cms   #clinicians

COVID-19: Telehealth Video, Coinsurance and Deductible Waived, ASC Attestations, Ambulance Modifiers, Lessons From Front Lines, MLN Call Today

04/07/2020
#cms   #telehealth

The American Academy of Opthalmology has published a collection of resources related to Coronavirus and Eye Care for Ophthalmologists, Practice Managers, and Eye Health Patients.

#opthalmology

All About Vision has published an article going into detail on seeing patients via virtual visits.

#telehealth

CMS Publishes Letter to All Clinicians covering Telehealth, Reporting, Advanced Payments and more.

#cms   #clinicians

Professional Telehealth Billing During COVID-19 Public Health Emergency

Professional Telehealth Billing During COVID-19 Public Health Emergency Building on a prior action to expand reimbursement for telehealth services, the Centers for Medicare & Medicaid Services (CMS) now allows for more services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the COVID-19 public health emergency (PHE), bill with:
  • The place of service (POS) that would have been used had the service been furnished in person
  • Modifier 95, indicating that the service rendered was actually performed via telehealth
As a reminder, CMS is not requiring the CR modifier (catastrophe/disaster) on telehealth services. However, consistent with current rules for telehealth services, there are two scenarios where modifiers in addition to modifier 95 are required on Medicare telehealth professional claims:
  • When furnished as part of a federal telemedicine demonstration project in Alaska or Hawaii using asynchronous (store and forward) technology, use the GQ (asynchronous telecommunications system) modifier
  • When furnished for diagnosis and treatment of an acute stroke, use G0 (zero) modifier to indicate a telehealth service furnished for purposes of diagnosis, evaluation, or treatment of symptoms of an acute stroke.
There are no telehealth billing changes for institutional claims, and critical access hospital Method II services should continue to be reported with modifier GT to indicate the service was provided via an interactive audio and video telecommunications system. Remember, virtual check-ins and E-Visits are not Telehealth services. Modifier 95 should not be used with CPT/HCPCS codes for those services. Any DuxWare Customer that utilizes our Claim Scrubbing Interface automatically received these updates.
#telehealth   #cms   #duxware   #claimscrubbing

CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

#waivers  #cms

Medicare Learning Network publishes a video to answer common questions about Medicare Telehealth services benefit.

#telehealth   #cms

Keep yourself up to date on all the news from CMS related to the current emergency.

#cms   #covid19

Lessons from the Front Lines.

On April 3, CMS Administrator Seema Verma, Deborah Birx, MD, White House Coronavirus Task Force, and officials from the FDA, CDC, and FEMA participated in a call on COVID-19 Flexibilities. Several physician guests on the front lines presented best practices from their COVID-19 experiences. You can listen to the conversation.
#cms    #lessonsfromthefrontlines

COVID-19: Expanded Use of Ambulance Origin/Destination Modifiers

During the COVID-19 Public Health Emergency, Medicare will cover a medically necessary emergency and non-emergency ground ambulance transportation from any point of origin to a destination that is equipped to treat the condition of the patient consistent with state and local Emergency Medical Services (EMS) protocols where the services will be furnished. On an interim basis, we are expanding the list of destinations that may include but are not limited to:

  • Any location that is an alternative site determined to be part of a hospital, Critical Access Hospital (CAH), or Skilled Nursing Facility (SNF)
  • Community mental health centers
  • Federally Qualified Health Centers (FQHCs)
  • Rural health clinics (RHCs)
  • Physicians’ offices
  • Urgent care facilities
  • Ambulatory Surgery Centers (ASCs)
  • Any location furnishing dialysis services outside of an End-Stage Renal Disease (ESRD) facility when an ESRD facility is not available
  • Beneficiary’s home
  • CMS expanded the descriptions for these origin and destination claim modifiers to account for the new covered locations:
  • Modifier D – Community mental health center, FQHC, RHC, urgent care facility, non-provider-based ASC or freestanding emergency center, location furnishing dialysis services and not affiliated with ESRD facility
  • Modifier E – Residential, domiciliary, custodial facility (other than 1819 facility) if the facility is the beneficiary’s home
  • Modifier H – Alternative care site for hospital, including CAH, provider-based ASC, or freestanding emergency center
  • Modifier N – Alternative care site for SNF
  • Modifier P – Physician’s office
  • Modifier R – Beneficiary’s home
#cms

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