COVID-19 Vaccine Coding
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The U.S government is already acting swiftly and strategically to make the new vaccine available to the hospitals and practices across the country.
T he COVID-19 Vaccine approval means that Hospitals and Practices would need to revisit their medical coding strategies to stay on top of the vaccination initiatives.
The U.S Food and Drug Administration (FDA) announcement on the Emergency Use Authorization (EUA) of COVID-19 vaccine to Pfizer-BioNTech has been a key focus area for providers. However, the healthcare ecosystem is just starting to get attuned to the COVID-19 vaccine billing and coding strategies.
The U.S government is already acting swiftly and strategically to make the new vaccine available to the hospitals and practices across the country. The government-acquired doses are also soon making their way to the healthcare organizations as they get approved by the Food and Drug Administration (FDA).
Hospitals and practices would ideally be submitting claims on vaccine bought from drug manufacturers, whereas the providers cannot claim vaccines received for free of costs. However, the vaccine administering charges can be claimed separately by the providers. New Medical codes and guidelines related to COVID-19 have been announced and the healthcare ecosystem is adopting these codes for their COVID-19 related claim submissions.
To begin with, the World Health Organization (WHO) has created the (ICD-10-CM) code for COVID-19: U07.1 COVID-19. The Centers for Disease Control and Prevention (CDC) soon adopted the code as the global pandemic was later announced as a Public Health Emergency (PHE). The Centers for Medicare and Medicaid Services (CMS) has also quickly made several new initiatives and introduced new codes for COVID-19 treatments and vaccines.
CMS reinstates that these new codes will pertain to therapeutics like monoclonal antibodies and vaccines for COVID-19 treatment. CMS has also confirmed that the Medicare payment will be made separately for the vaccine and its administration costs. Hospitals and Practices need to ensure that the right Current Procedural Terminology (CPT) codes are used to document when providing the vaccine to a Medicare beneficiary.
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The American Medical Association (AMA) has developed new and specific CPT codes to facilitate reimbursements for COVID-19 vaccines. Unique codes have been developed for Pfizer-BioNTech vaccine (authorized for emergency use), a vaccine from a Pharma company named Moderna (under review by FDA) and AstraZeneca, Plc respectively.
With the right medical coding strategies and reimbursement plans, Providers can get timely reimbursements for COVID-19 vaccines. For instance, CMS has announced that Medicare reimbursements will be provided for FDA approved vaccines. Various other factors also contribute to the timely and appropriate reimbursements for administering COVID-19 vaccines like the reimbursement models.
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To stay on top of the latest COVID-19 innovations and updates, stay tuned to our blog section.
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