Billing for COVID-19: Update

computer generated image of Covid-19 virus in tube lined with 0s and 1s

March 19, 2021

Nikki E. Graves, MBA, CHFP
Senior Revenue Cycle Consultant
PARA HealthCare Analytics, a division of Healthcare Financial Resources, LLC

The COVID-19 pandemic continues to cause extreme financial hardship for hospitals, health systems and all providers. Hospital operating margins through October 2020 fell 18.7%[1] while claim denials increased on average by 23 percent in 2020 compared to 2016[2]. These market dynamics make it even more important to stay abreast of regulatory changes regarding COVID-19.
With the pandemic has come increased and frequently changing COVID-19 regulations and guidelines. To help you stay on top of these changes, PARA HealthCare Analytics, a division of Healthcare Financial Resources, continues to update COVID-19 coding and billing information from the Centers for Medicare and Medicaid (CMS) and payers.

What you will find in this important update

  • Link to the CDC ICD-10 tool
  • Updated information on Remdesivir
  • FDA-approved COVID-19 treatment for most adults
  • New Medicare Administrative Contractor (MAC) payment link and table for pricing of COVID-19 lab tests
  • Updated language for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) regarding billing of monoclonal antibodies (MAB) and vaccines
  • Easier to read sections for condition codes and modifiers
  • New information on controlled release and controlled delivery
  • Additional coding information related to COVID-19

To read the full Covid-19 coding document, click here.

Keeping it all straight

Staying abreast of the latest COVID-19 coding regulations can be a challenge, and it can be doubly so during the pandemic when resources may be tight. That’s why PARA HealthCare Analytics, a division of Healthcare Financial Resources Inc. (HFRI) keeps you updated on all the latest COVID-19 coding initiatives. Together, PARA and HFRI deliver comprehensive revenue cycle services to support accurate coding, clean claims, accounts receivable recovery and resolution services, and timely and appropriate reimbursement. Contact us today to learn more about the many ways we can help your organization.

[1] Robert King, “Hospital operating margins down nearly 20% since start of year due to COVID-19, report says,” Fierce Healthcare, Nov, 30, 2020.
[2] Jacqueline LaPointe, “Hospital Claim Denials Steadily Rising, Increasing 23% in 2020,” Revenue Cycle Intelligence, Feb 4, 2021.

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