COVID-19 Updates
New Codes for Moderna Vaccine Booster Doses
On March 29, 2022, the FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF), including new packaging for vaccine boosters (blue cap). CMS issued new codes, effective March 29, 2022, for the vaccine booster and administration: Code: 91309 Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free,…Read More
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Changes
On December 16, 2021, CMS announced the Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare Fee-for-Service (FFS) claims: No payment adjustment through March 31, 2022 1% payment adjustment April 1 – June 30, 2022 2% payment adjustment beginning July 1, 2022Read More
COVID-19: Moderna & Jansen (J&J) Booster Shots
Effective October 20, 2021, FDA amended the emergency use authorizations for the Moderna (PDF) and Jansen (Johnson & Johnson) COVID-19 vaccines to allow for use of a single booster dose for certain populations. More CMS Resources: COVID-19 Vaccines and Monoclonal Antibodies Payment Allowances & Effective Dates CMS News Alert Regarding COVID-19 Booster Coverage COVID-19 provider toolkit including: Payment rates for administering…Read More
AMA – Update to COVID-19 Vaccine CPT Codes
The American Medical Association (AMA) announced on September 3, 2021 that the CPT code set has been updated by the CPT Editorial Panel to include vaccine and administration codes that are unique to a new formulation of the COVID-19 vaccine developed by Pfizer. The new formulation is based on a tris-sucrose buffer rather than the…Read More
New CPT Codes for third Pfizer and Moderna COVID-19 Vaccine Dose
The American Medical Association (AMA) announced on August 16, 2021, that the Current Procedural Terminology (CPT®) code set is ready for the rollout of third doses of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has expedited approval of a new administration code that is unique to a third dose of the current…Read More
CMS: Accelerated and Advanced Remit Reminders
If you received an accelerated or advance payment, the Centers for Medicare & Medicaid Services (CMS) will begin to recoup any outstanding balance from any payments due to you from your Medicare claims. This process began as soon as 3/30/2021, depending upon the one-year anniversary of when you received your first advance payment. CMS will…Read More
NYSIIS COVID-19 Submissions Must include Priority Group
The ChartMaker® Medical Suite has been updated to allow users to attach the Priority Group to their Covid-19 immunization submissions. NYSIIS is currently accepting information for the following vaccines: Vaccine (ID) Name CVX Code Trade Name Manufacturer Code COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5 mL dose 207 Moderna COVID-19 Vaccine MOD COVID-19, mRNA, LNP-S, PF,…Read More
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended through December
On April 16, 2021, CMS announced that the 2% Payment Adjustment (Sequestration) for Medicare FFS Claims have been suspended through December: The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December 31, 2020. The Consolidated Appropriations…Read More
COVID-19 Vaccine and Administration Codes, Payment Allowances & Effective Dates
The COVID-19 Vaccine is here and is ready to be administered. As providers the next big step is to procure the vaccine and administer it. Likewise, it is important to know that Medicare will cover and pay for the administration of the vaccine, when furnished consistent with the Emergency Use Authorization (EUA). The payment and…Read More
CDC Announces 6 New ICD10 Codes for COVID-19 Effective 01/01/2021
On December 3, 2020, the CDC announced six (6) new ICD10 diagnosis codes to identify conditions resulting from COVID-19. These ICD10 Codes will become effective on January 1, 2021. The new codes are: Z11.52 – Encounter for screening for COVID-19 Z20.822 – Contact with and (suspected) exposure to COVID-19 Z86.16 – Personal history of COVID-19…Read More