FWA Briefs

On May 19, 2021, the Medicare Payment Advisory Commission (MedPac) provided feedback to Congress regarding their opinions on the effectiveness of the overwhelming 200 healthcare policy changes that Congress and CMS instituted during the interval of January through July 2020, in response to the coronavirus public health emergency. Aside from the obvious and necessary benefits of these changes in response to the pandemic, MedPac raises concerns about the detrimental impact in the realm of fraud in healthcare: “…not all actors in the healthcare system are well-intentioned”.

Relaxed telehealth restrictions is a necessary step to limit potential COVID-19 exposure in physician offices in the emergency period. With this change, unfortunately, the US Justice Department estimates telehealth-related fraud has expanded significantly since early 2020 – approximated at 4.5 billion dollars.

The American Dental Association® (ADA) will add 28 new CDT codes effective January 1, 2021, along with seven (7) code revisions, four (4) code deletions and 22 editorial changes. Among the new CDT code additions for 2021 are two (2) new coronavirus testing codes and a code related to counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use.

In response to the Novel Coronavirus pandemic, a new ICD-10-CM code was moved up from previous posted effective date of October 1, 2020. The new ICD-10-CM diagnosis code, U07.1, is effective April 1, 2020.