Physicians are anticipated to benefit from emerging medical billing and coding trends as the healthcare market continues to change.
Fremont, CA: Increased regulations, advanced digital technologies, data interoperability, the shift to value-based payment models, changing consumer expectations and demographics, insurance providers' policies, and innovative care delivery methods such as telemedicine all contribute to the ever-changing nature of the U.S. healthcare industry. The COVID-19 pandemic has significantly impacted the healthcare revenue cycle over the past two years. Centers for Medicare and Medicaid Services (CMS) predict that federal health care spending would rise 36.0 percent in 2020, compared to just 5.9 percent in 2019. The COVID-19 pandemic was largely responsible for this quicker growth. Medical billing and coding services have seen a steady stream of innovation to keep pace with the ever-changing landscape of healthcare.
Trends that will impact medical billing and coding in 2022:
FY 2022 inpatient prospective payment system (IPPS)
For the fiscal year (FY) 2022, the Medicare Hospital IPPS final rule announced in August 2021 raises compensation for hospitals by 2.5 percent and also increases prices for COVID-19 tests and treatments. On October 1, 2021, these amendments went into effect. Medicare severity diagnosis-related group (MS-DRG) changes are included in the 2022 final rule, which contains new diagnostic and procedure codes. Fiscal year (FY) 2022 inpatient prospective payment system is the answer for coding departments, according to a For the Record Magazine article (IPPS). Improvements in data reviews and quality measurement are outlined in the FY 2021 IPPS final regulation.
Medicare Physician Fee Schedule 2021
The first significant adjustments to the Medicare Physician Fee Schedule in over a decade were enacted in the 2021 Medicare Physician Fee Schedule. There were adjustments to how E/M services should be reported and higher and lower payments for various specialties, and an expansion of Medicare's list of covered telehealth services. In terms of medical billing and coding, all of this has a substantial impact.
Documenting and billing virtual visits
Outpatient visits were replaced by virtual appointments using the COVID-19. The pre-COVID-19 baseline telehealth utilization climbed 38 times in 2021, according to a Mckinsey study. For virtual visits, Medicare and commercial payers have specific payment requirements as a result of COVID-19, which is constantly changing the rules. Coders and billing personnel have to learn new documentation and billing procedures while coping with constant policy and regulation shifts. Some other variables driving telemedicine use in 2022, in addition to pandemics, are the rising incidence of chronic diseases, an aging population, and shortages of doctors. New billing procedures, including the use of modifiers, apply to E&M visits when using telehealth codes.