Understand the changes in medical billing rules & regulations and predict how medical billing will be in 2021 to increase your medical business growth.
3. • 2020 has been a challenging year for Global
healthcare sector, which resulted in sweeping
changes affecting healthcare and Medical billing
outright.
• With these challenges and changes anticipated to
carry over, Medical Billing in 2021 as predicted will
see a lot of updates, advancements, revised medical
billing and coding guidelines, compliances and
regulation.
• Read further to educate yourself with the latest
changes in Medical billing.
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4. American Medical Associates (AMA) announced major
updates in medical billing codes and guidelines for
2021. Release of an updated version of CPT (Current
Procedural Terminology) codes includes modification of
codes for outpatient evaluation and management (E/M)
services as listed below:
• Eliminating history and physical exam as elements
for code selection.[1]
• Allowing physicians to choose the best patient care
by permitting code level selection based on medical
decision-making (MDM) or total time.[1]
• Promoting payer consistency with more detail added
to CPT code descriptors and guidelines.[1]
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5. Further to the above E/M coding changes; around 329 CPT codes have been edited for 2021 code set
inclusive of
• 206 new codes – Important additions are in
response to COVID- 19
• 54 deletions – CPT code sets are continuously
modified to keep up with the fast-paced innovation
in digital medicines
• 69 revision of existing codes – to meet the current
requirement
• Updated CPT codes for technological advances in
Cardiac monitoring and detection
• Revision and addition of codes set for Retinal
Imaging and screening diabetic retinopathy and
increase early detection
• Descriptive codes for Artificial Intelligence (AI)
and technology augmented solutions
• Of the new codes introduced, the majority of codes
are updated to cover the novel areas of medicine
and almost 63% involves in new technological
services in healthcare.
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6. While the revision of CPT codes is closely monitored for better reimbursement, it is of prime importance to know
what remains the same.
Guidelines for new and established patients remain intact
Use of CPT code 99211 still remains unchanged.
Requirement of clinical documentation by physicians
CPT manual for shared/split services is similar to previous versions
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7. Tele-health and Tele-medicine emerged as the best solution during Novel COVID-19 Pandemic.
It ultimately served as an alternative option for patient care by helping to maintain social distancing.
Owing to growth in Telehealth and Tele-medicine, related industry-based digital tools and information
technology are trending.
Recent research concludes that majority of patients embrace Tele-health and digital interactions compared to
regular medical services.
As a result of the ongoing crisis and surge in the current requirement, Tele-health is expected to see about 80%
of growth.
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8. 8
Medical Billing Outsourcing
Medical Billing Outsourcing market is witnessing an
increased growth due to the changes and twist
involved due to the COVID-19 pandemic and majorly
because of the complexity in keeping abreast of the
recent CPT and ICD-10 coding guidelines, changes
in medical billing rules and regulations, etc.
Physicians and medical groups are considering
Medical billing outsourcing to cope up with the
industrial changes.
About MGSI
MGSI is a 25 years old national Medical Billing
Company serving more than 600 physicians across
US. MGSI has trained and experienced medical
billing and coding team handling complete revenue
cycle management services to our clients.
We also have the prerequisite to facilitate your
medical billing and education your providers and
team with all compliant and regulatory policies.
To know more about the recent changes in Medical
Billing and to outsource your RCM process contact
MGSI
www.mgsionline.com
