Hospital Claims Review Resource Available
Livanta, Medicare’s national claims review contractor, has launched the Livanta Claims Review Advisor — a monthly online educational resource for medical coders, billing, financial and revenue cycle personnel, clinical documentation improvement specialists, utilization review coordinators, case managers, compliance officers, physicians, and other practitioners.
CMS Releases Billing Codes for Johnson & Johnson, Moderna Booster Shots
On Oct. 20, the Food and Drug Administration amended the emergency use authorization for COVID-19 vaccines to allow booster doses for the Moderna and Johnson & Johnson vaccines. The Centers for Medicare & Medicaid Services has released new billing coding for the Johnson & Johnson and Moderna COVID-19 vaccine booster shots. Current billing codes, payment allowances, and effective dates are available online.
CMS to Pay for COVID-19 Booster Shots
The Centers for Medicare & Medicaid Services has announced will pay the full cost of the Pfizer-BioNTech COVID-19 booster shots to providers without cost-sharing for Medicare, Medicaid, and the Children’s Health Insurance Program beneficiaries.
CMS Issues No Surprises Act Enforcement Provisions Proposed Rule
On Sept. 10, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule detailing the enforcement provisions related to the No Surprises Act (NSA). The proposed rule:
FDA Announces Approval of Pfizer-BioNTech COVID-19 Vaccine
The Food and Drug Administration (FDA) today announced its full approval for the Pfizer-BioNTech COVID-19 vaccine — under the name Comirnaty — for individuals 16 and older, making it the first COVID-19 vaccine to go beyond emergency use authorization (EUA) in the U.S.
Additional mRNA Vaccine Dose Authorized for ‘Moderately to Severely Immunocompromised’ Individuals
On Aug. 12, the Food and Drug Administration (FDA) expanded the emergency use authorization (EUA) for both the Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals ages 12 and older. Following that announcement, the Centers for Disease Control and Prevention issued a recommendation that “people whose immune systems are compromised moderately to severely should receive an additional dose of mRNA vaccine after the initial 2 doses.”
CDC Announces COVID-19 Vaccine Boosters for All, CMS Updates Coding Guidance
The Centers for Disease Control and Prevention (CDC) announced plans to begin offering COVID-19 booster shots to all individuals beginning the week of Sept. 20 and starting eight months after an individual’s second dose, pending authorization from the Food and Drug Administration (FDA) and a review by the CDC’s vaccine advisory committee.
CHA Webinar on No Surprises Act Will Detail Implementation for California Hospitals
CHA will host a complimentary, members-only webinar on Aug. 6 from 9 to 10 a.m. (PT) to discuss implementation of the No Surprises Act and to help members understand the notice and consent process, along with qualifying payment calculation.
CMS To Host National Stakeholder Call on No Surprises Act Interim Final Rule
The Centers for Medicare & Medicaid Services (CMS) will host a national stakeholder call at 12:30 p.m. (PT) on July 22 to discuss the interim final rule with comment period implementing the No Surprises Act, which addresses surprise medical billing at the federal level.
Initial Surprise Bill Medical Billing Regulations Issued by Tri-Agencies
On July 1, the Departments of Health and Human Services, Labor, and Treasury (tri-agencies) released an interim final rule implementing the No Surprises Act.