COVID-19 Resources for Hospitals

Published: March 26,2020  |  Last Updated June 2, 2020

Versalus Health created this COVID-19 Resources page to provide you with relevant coronavirus information addressing questions related to regulatory changes that impact hospital Utilization Management/Utilization Review, Documentation, Coding, Compliance, and Revenue Cycle. We are including links to pertinent information to address many of the questions we've received in recent weeks. We plan to update this daily as we become aware of new information.

Latest Updates

• SE20011 Revised - Clarification for Using the “CR” Modifier and “DR” Condition Code. (06-02-2020)  - NEW
• CMS Fact Sheet for COVID-19 Survey Activities, CARES Act Funding, Enhanced Enforcement for Infection Control deficiencies, and Quality Improvement Activities in Nursing Homes  (06-01-2020) - NEW
• State and Local Governments - CMS Programs & Payment for Care in Hospital Alternate Care Sites (05/26/20) - NEW
• COVID-19: Adjusting Operations to Manage Patient Surge (04/24/20) - NEW
• OIG announces audit of CARES Act Provider Relief Funds-Distribution of $50 Billion to Health Care Providers (05/26/20) - NEW
• HHS Announces 45-Day Compliance Deadline Extension for Providers (05/22/20) - NEW
• Providers Must Act by June 3, 2020 to Receive Additional Relief Fund General Distribution Payment (05/20/20) 
• HHS Extends Deadline for Attestation, Acceptance of Terms and Conditions for Provider Relief Fund Payments to 45 Days (05-07-2020) Recipients of payments from any of the allocations from CARES Act and Paycheck Protection Program and Health Care Enhancement Act must attest and accept the Terms and Conditions within 45 days. 
• Payment Protection Program Loans Frequently Asked Questions (FAQs) (5/04/20) Last question. Nonprofit hospitals meet the definition of “nonprofit organization” under section 1102 of the CARES Act
• UPDATE: CARES Act Provider Relief Fund - Description of Fund, General Distribution and Targeted
  • General Distribution Portal FAQs
  • CARES Provider Relief Fund Application Portal - Portal to apply for additional funds
  • CARES Act Provider Relief Fund Application Guide
• HRSA: COVID-19 Claims Reimbursement to Providers and Facilities for Testing and Treatment of the Uninsured
• COVID-19 Uninsured Program Claims Reimbursement - Program Portal information

Centers for Medicare & Medicaid Services (CMS)

Current Emergencies CMS Website - This page includes general information & updates; press releases; clinical & technical guidance; billing & coding guidance; survey & certification guidance; coverage guidance; and Medicaid & CHIP guidance.

LATEST UPDATES

• Second Round of Sweeping Changes to Support U.S. Healthcare System During COVID-19 Pandemic (04/30/20) 
• CMS Recommendations for Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I  (04/19/20) 
• CMS - Nursing Home Reopening Recommendations for State and Local Officials (05/18/20) 
• CMS Implements Flexibilities for the Quality Payment Program—COVID-19 Response (4/30/20) 
• CMS Non-Emergent, Elective Medical Services, and Treatment Recommendations (04/07/20) 
• CMS Rulings CMS-2020-1  - Payment under Medicare Supplementary Medical Insurance (Part B) for clinical diagnostic laboratory tests for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19 making use of high throughput technologies. (04-14-2020)
• New Medicare Outpatient Observation Notice (MOON) - Hospitals are strongly encouraged to begin using the new MOON as soon as possible, but no later than May 1, 2020  (04-06-2020)
  • All Beneficiary Notices - See MLN Matters regarding Beneficiary Notice Delivery Guidance in light of COVID-19
• CMS News Alert Summary (03-30-2020) 
• CMS-1744-IFC - Interim Final Rule
• Sweeping Regulatory Changes to Help US Address COVID-19 - See 03-30-2020 waiver updates below (03-30-2020)  
  • 2019-Novel Coronavirus (COVID-19) Provider Burden Relief Frequently Asked Questions (FAQs)  - CMS is suspending most Medicare Fee-For-Service (FFS) medical review during the Public Health Emergency  (03-30-2020) 
• Trump Administration Engages America’s Hospitals in Unprecedented Data Sharing (03-29-2020) 
  • Reporting instructions (03-29-2020)  
• CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment Program (04-26-2020)
  • UPDATED Fact Sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency - Beginning on April 26, 2020, CMS will not be accepting any new applications for
    the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments. 
• Financial Relief for Medicare Providers (03-28-2020)
  • Fact Sheet: Expansion of the Accelerated and Advance Payments Program for Hospitals/Health Systems - Instructions on how to request advanced payment from your MAC  (03-28-2020)

WAIVERS

• COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (5/15/20) 
• Summary of COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (Revised 04-09-2020) 
• Hospitals: CMS Flexibilities to Fight COVID-19 (03-30-2020) 
• Medicare FFS: Emergency-Related Policies and Procedures That May Be Implemented Without § 1135 Waivers (03-15-2020)
• Waiver or Modification of Requirements Under Section 1135 of the Social Security Act (03-13-2020)
• Emergency Declaration Fact Sheet - List of blanket waivers available to providers during the COVID-19 emergency (03-13-2020)
• Blanket Waivers of Section 1877(g) of the Social Security Act Due to Declaration of COVID-19 Outbreak (03-01-2020)
• Approved Waivers by State - Approved Section 1135 Waiver Flexibilities (Updated daily)
  • Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19 - Kaiser Family Foundation visual tracker 
• Waivers overview
  • 1135 Waiver- At A Glance
  • Requesting a 1135 Waiver Waiver
  
  MLN CONNECTS (Newsletter)

• CMS weekly newsletters - Listing of all MLN Newsletters published by CMS
  • COVID-19: Reprocessing Hospital Claims, Essential Diagnostic Services, Non-Invasive Ventilators (04-15-2020)
  • COVID-19: Infection Control, Maximizing Workforce, Updated Q&A, CS Modifier for Cost-Sharing, Payment Adjustment Suspended (04-10-2020) 
  • MLN Connects for April 9, 2020 - Advanced Payment updates, Dear Clinician Letter, Non-Emergent, Elective Medical Services and Treatment Recommendations (04-09-2020) 
  • COVID-19: Telehealth Video, Coinsurance and Deductible Waived, ASC Attestations, Ambulance Modifiers, Lessons From Front Lines, MLN Call Today (04-07-2020)
  • COVID-19: Telehealth Billing Correction, Nursing Home Recommendations, Billing for Multi-Function Ventilators, New ICD-10-CM Diagnosis Code (04-03-2020)
  • COVID-19: Regulatory Changes, Telehealth Billing, and Specimen Collection Codes (03-31-2020)
  • COVID-19: Financial Relief, Nursing Home Telehealth, Quality Reporting, Clinical Laboratories, Hospital Data Sharing (03-30-2020)
  • Beneficiary Notice Delivery Guidance in light of COVID-19 (03-26-2020)
  • COVID-19: Telehealth and Non-Essential Procedures (03-20-2020)
  • Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak (03-17-2020)
  • COVID-19: New ICD-10-CM Code and Interim Coding Guidance (02-27-2020)

MLN Matters Articles

• MLN Matters are articles and transmittals explaining national Medicare policy - Listing of MLN Matters published  in  2020
  • New Waivers for Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) due to Provisions of the CARES Act (04-15-2020)
  • Medicare Fee-for-Service (FFS) waivers & claims instructions (03-20-2020)  Revised (04-10-2020)
  • Transmittal 10029 - Update to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for Vaping Related Disorder and 2019 Novel Coronavirus (COVID-19)
  • MM11623 Revised - Update to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for Vaping Related Disorder and 2019 Novel Coronavirus (COVID-19) (04-02-2020)
  • April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) (03-25-2020)
  • Transmittal 10013 - April 2020 Update of the Hospital Outpatient Prospective Payment (03-25-2020)

FACT SHEET & FAQs

• Medicare Fact Sheet - Coverage and Payment Related to COVID-19  (03-23-2020) 
• Medicaid Fact Sheet - Coverage and Benefits Related to COVID-19 (03-05-2020)
• FAQs - COVID-19 FAQs - CMS addresses COVID-19 frequently asked question (Updated 03-23-20) 
• FAQs - Essential Health Benefit Coverage and the Coronavirus (COVID-19) (03-12-2020)

CODING

• MS-DRG Classifications and Software
  • ICD-10 MS-DRGs Version 37.1 R1 Effective April 1, 2020 - GROUPER software package (V37.1 R1) replaces the GROUPER software package V37.1 that was developed in response to the new ICD-10-CM diagnosis code U07.0 (03-23-2020)
  • ICD-10 MS-DRGs Version 37.1 Effective April 1, 2020
  • CMS Develops Additional Code for Coronavirus Lab Tests (03-06-2020) 
• Medicare Administrative Contractor (MAC) COVID-19 Test Pricing (03-12-2020)

TELEMEDICINE

• Telehealth Video: Medicare Coverage and Payment of Virtual Services (5/11/20) 
• HHS telehealth guidance & information
• MLN Medicare Coverage and Payment of Virtual Services (04-10-2020)
• General Telemedicine Toolkit (03-20-2020)
• Medicare Telemedicine Provider Fact Sheet (03-17-2020)
• FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage (03-24-2020)

ADDITIONAL INFORMATION

• CMS Dear Clinician Letter - Letter to clinicians informing them that if they participate in a COVID-19 clinical trial and report their findings, they many earn credit  for Merit-Based Incentive Payment System (MIPS)  (04-28-2020)
• CMS Dear Clinician Letter (04-07-2020)
• Nursing Homes: Upcoming Requirements for Notification of Confirmed COVID-19 Among Residents and Staff in Nursing Homes (04-19-2020) 
• Long-Term Facility: 2019 Novel Coronavirus (COVID-19) Long-Term Care Facility Transfer Scenarios (04-13-2020) 
• Medicaid State Plan Amendments - A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs
• Guidance for Processing Attestations from Ambulatory Surgical Centers (ASCs) Temporarily Enrolling as Hospitals during the COVID-19 Public Health Emergency (04-03-2020) 
• Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19) (Revised) (03-30-2020)
• Exceptions and Extensions for Quality Reporting Requirements for Acute Care Hospitals (03-27-2020)
• Quality Reporting Programs Relief for Clinicians, Providers, Hospitals and Facilities (03-22-2020)
• CMS Adult Elective Surgery and Procedures Recommendations - Recommendations to limit all non-essential planned surgeries and procedures, including dental, until further notice (03-15-2020)
• CMS Memo to Medicare Advantage Organizations, Part D Sponsors, and Medicare-Medicaid Plans - COVID-19 (03-10-2020)
• Non-Emergent, Elective Medical Services, and Treatment Recommendations (04-06-2020)

Health and Human Services (HHS)

• CARES Act Provider Relief Fund Payment Attestation Portal  - Providers who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment. 
• CARES Act Provider Relief Fund Overview
• Relief Fund Payment Terms and Conditions
• HHS Begins Distribution of Payments to Hospitals with High COVID-19 Admissions, Rural Providers  (5/04/20) 
• Families First Coronavirus Response Act (FFCRA), Coronavirus Aid, Relief, and Economic Security (CARES) Act, Frequently Asked Questions (FAQs)  (04-13-2020)
• FAQs about Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation Part 42  (04-11-2020)
• HHS to Begin Immediate Delivery of Initial $30 Billion of CARES Act Provider Relief Funding  (04-10-2020)

Centers for Disease Control and Prevention (CDC)

• Coronavirus (COVID-19) - Overview page
• States Reporting Cases of COVID-19 to CDC - Cases in U.S.
• Information for Healthcare Professionals:
  • Healthcare Facilities
  • Health Departments
  • Frequently Asked Questions and Answers
  • Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease
• CDC - Activities and Initiatives Supporting the COVID-19 Response for Opening America Up Again -  the CDC released official reopening guidelines this week (05/12/20) 
• CDC - Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic (05/12/20)
  

Coding Related Information

• ICD-10-CM Official Coding and Reporting Guidelines April 1, 2020 through September 30, 2020
• ICD-10-CM Official Guidelines for Coding and Reporting FY 2020 (October 1, 2019 - September 30, 2020)
• International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)
• Announcement New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19) (03-18-2020)
• New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), October 1, 2020 (02-20-2020)
• ICD-10-CM Tabular List of Diseases and Injuries  April 1, 2020 Addenda(02-2020)
• Interim Coding Guidance - ICD-10-CM Official Coding Guidelines - Supplement Coding encounters related to COVID-19 Coronavirus Outbreak (02-20-2020)
  
  Other Coding Information

• AHA Coding Clinic: Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19 (04-28-2020) 
• AHIMA and AHA FAQ: ICD-10-CM Coding for COVID-19 (04-17-2020) 

American Medical Association (AMA) Coding Guidance

• AMA COVID-19 coding and guidance
• AMA - CPT Assistant - AMA Fact Sheet - Reporting Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) Laboratory Testing
• AMA - CPT© reporting for COVID-19 Testing
• AMA -Special Coding Advice  Related to COVID-19

Note: CPT © Copyright 2020 American Medical Association. All rights reserved. AMA and CPT are registered trademarks of the American Medical Association.

Additional COVID-19 Resources

• State by state - COVID-19 information
• AHA, others release additional guidance for resuming elective surgeries  (05/20/20) 
• Joint Statement AHA and others: Roadmap for Resuming Elective Surgery after COVID-19 Pandemic (04-17-2020)  
• American College of Surgeons: Local Resumption of Elective Surgery Guidance (04-17-2020)  
• American College of Surgeons: Guidance for Triage of Non-Emergent Surgical Procedures (03-17-2020) 
• AHA - Updates and Resources on Novel Coronavirus (COVID-19)
• The New England Journal of Medicine (NEJM) - COVID-19
• PubMed  -  US Library of Medicine COVID-19 articles available in full 

Versalus Health

Perspective

• COVID-19 CARES Act: Hospitals Must Proceed Carefully  -  A Versalus Health Perspective

Resource Center

The Versalus Health Resource Center includes several educational tools for hospitals related to COVID-19 including: 

• WEBINAR: Coronavirus: Utilization Management, Documentation & Coding Recommendations to Ensure Appropriate Reimbursement
• BULLETINS
• FAQs 

To access the recording, please register here

Contractors

• Medicare Administrative Contractors

  • Medicare Administrative Contractor (MAC) COVID-19 Test Pricing (05-19-2020) 
  • Part A MACs COVID-19-related information, phone numbers, and links to the advanced payment forms - information you'll need if you decide to apply for an advanced/accelerated payment
  • Medicare Administrative Contractor (MAC) COVID-19 Test Pricing (03-12-2020)

  BFCC-QIO

  • KEPRO - COVID-19 information 
  • LIVANTA - COVID-19 information

Health Insurers Information

• AHIP - America’s Health Insurance Plans response to COVID-19 
• Aetna - CVS Health - What you need to know about the coronavirus (COVID-19) for Providers
  • Temporary Changes in Prior
    Authorization/Precertification and Admissions Protocols
    
• Cigna - response to COVID-19
• Humana - Coronavirus disease 2019 (COVID-19)
  •  Administrative Updates 
• UnitedHealthcare - COVID-19 Information & Resources
  • COVID-19 Prior Authorization - Post-Acute Care, Transfers and Site of Service 
  • Claim Coding, Submissions and Reimbursement