Healthcare providers across the United States have been working hard to distribute the COVID-19 vaccine to as many people as possible as quickly as possible. There are four different vaccines, three of which have already been granted emergency use authorization by the FDA. The American Medical Association (AMA) has issued CPT codes for each of the different vaccines

What Vaccines Are Available in the United States?

There are currently four vaccines that have been developed to protect people from the COVID-19 virus. These vaccines are:

• Pfizer-BioNTech COVID-19 Vaccine by Pfizer, Inc.
• Moderna COVID-19 Vaccine by Moderna, Inc.
• Janssen COVID-19 Vaccine by Janssen (Johnson & Johnson)
• AstraZeneca COVID-19 Vaccine by AstraZeneca

Of these, the Pfizer, Moderna, and Janssen (Johnson & Johnson) vaccines have been granted emergency use authorization by the FDA in the United States. AstraZeneca has not yet been approved due to discrepancies in the data submitted to the FDA.

What Are the CPT Codes for Each Vaccine?

The CPT codes for each vaccine are as follows:

Pfizer

• Vaccine Code: 91300
• Vaccine Administration Code (1st Dose): 0001A
• Vaccine Administration Code (2nd Dose): 0002A
• NDC 10: 59267-1000-1
• NDC 11: 59267-1000-01

Moderna

• Vaccine Code: 91301
• Vaccine Administration Code (1st Dose): 0011A
• Vaccine Administration Code (2nd Dose): 0012A
• NDC 10: 80777-273-10
• NDC 11: 80777-0273-10

Janssen (Johnson & Johnson)

• Vaccine Code: 91303
• Vaccine Administration Code: 0031A
• NDC 10: 59676-580-05
• NDC 11: 59676-0580-05

AstraZeneca

• Vaccine Code: 91302
• Vaccine Administration Code (1st Dose): 0021A
• Vaccine Administration Code (2nd Dose): 0022A
• NDC 10: 0310-1222-10
• NDC 11: 00310-1222-10

These CPT codes will help physicians bill for the vaccines they are distributing.

Keeping accurate and up-to-date medical records can be a difficult proposition. With patients accessing health care in different places, different providers can have different information on the same patient. Accessing patient data can also be a hassle. Because of laws regarding patient privacy, most requests for patient records must go through the patient, which can take time.

Some companies, such as Medicalchain, are looking to change the world of medical records by using blockchain to create a secure way of sharing the latest patient data with multiple health care professionals at once, eliminating the middleman.

What Is Blockchain?

Blockchain is a digital ledger made up of records called blocks. It was initially designed in 2008 by someone (or a group of people) using the pseudonym Satoshi Nakamoto. Blockchain’s intended use at that time was to serve as a public ledger of transactions involving bitcoin. Blockchain records aren’t limited to recording cryptocurrency transactions, however. The distributed records of blockchain can be used to record and verify any transactions between two parties in a way that isn’t easily alterable.

How Does Blockchain Work?

Each block in a blockchain is linked to the next using cryptography and contains data from the previous block in the chain. It’s for this reason that blockchain is considered very secure. Although it’s not impossible to change data in a blockchain, it’s not easy to because the data would need to be changed in every subsequent block in the chain, making them very resistant to changes. Each entry in a block also contains a timestamp.

How Does Blockchain Improve Health Care Records?

Software companies such as Medicalchain use blockchain technology to create a centralized database of patient medical records. This centralized database has many advantages over the siloed system in use across much of the healthcare world.

Patients Must Opt-in

Patient privacy is still a major concern. Therefore, any patients whose records are stored with blockchain must opt-in to the service. From there, they can grant permission to health care professionals to access those records. They can retract that permission or grant permission for only a limited period of time. This helps healthcare professionals maintain compliance with patient privacy laws.

Centralized Records Database

Medical records stored with blockchain are kept in one centralized database. This means that healthcare professionals seeking access to patient records and information only need permission from the patient to access the files. There’s no middleman or waiting to receive transferred documents. The most up-to-date information is stored in one location shared by all healthcare professionals who have been granted access by the patient.

Health Care Records Are Collaborative

With patient records located in one centralized database, they’re more collaborative. A health care professional can make necessary additions to the records that are timestamped. Another health care professional can do the same without the records having to be transferred. All patient data from all relevant health care professionals can be kept in the same centralized record instead of separately.

Health Care Records Are Up-to-Date

When health care records are kept separate with each individual health care provider, there’s a risk that records aren’t the most up-to-date. This occurs when a change is made with one health care provider but others are unaware of the change. Blockchain-based medical records, on the other hand, are both centralized and timestamped so it’s easy to ensure that health care professionals are accessing the latest information.

Patients Get Better Care

When patient records are more accurate and easier to get, health care professionals can ensure that they’re providing the best possible care. With siloed records, there’s a risk of inadvertently using inaccurate information. Plus, if medical records are requested from another provider, the transfer can take some time. Accessing a centralized blockchain of medical records can make accessing patient data much faster, freeing up health care provider time and ensuring faster care for the patient.

Google Glass is a type of smart glasses released by Google in 2013. The glasses can project images on the inside of the lenses for wearers to view. They work like a smartphone but respond only to voice commands. You may remember the hype surrounding the smart glasses’ launch, but since then the glasses have mostly seemed to fade from the public eye.

Although Google Glass didn’t make the impact the company hoped for in the general public, but Google Glass turned out to have many useful applications in the field of medicine. Google Glass may be the most well-known smart glasses, but it’s not alone. Augmented reality technology in general can offer many benefits to doctors.

How Does Augmented Reality Help Doctors Treat Patients?

Time is of the essence when it comes to treating patients. Augmented reality technology can help doctors receive the information they need about patients quickly and easily. QR codes can transmit patient files to Google Glass or other smart glasses so the doctor can get the information they need immediately. Plus, because they’re transparent glasses, the doctor can maintain eye contact with the patient at the same time.

Instead of needing to read through paperwork first before attending to a patient, a doctor can focus on the patient while receiving the necessary information at the same time. Plus, the glasses are hands free and operate on voice commands, so the doctor can request more information, take pictures, and more.

How Does Augmented Reality Help Doctors Learn?

Augmented reality technology can also improve learning experiences for medical students and doctors in training. Images and videos of actual procedures can be taken and streamed to Google Hangouts with Google Glass. Students can watch procedures as well as tele-consultations.

How Does Augmented Reality Help Surgeons?

Google Glass and other augmented reality technologies can also help doctors in surgery. In a demonstration involving Google Glass in surgeries, a doctor were able to consult with colleagues while the surgery was going on as well as stream the procedure to students observing on laptops. The doctor performing the surgery said that the glasses were extremely intuitive and that the technology had fit seamlessly into the operating procedure.

The American Medical Association (AMA) recently announced the approval of a new addition to the CPT by the CPT Editorial Panel. This was done in an effort to improve tracking, allocating, and optimizing resources in the face of the COVID-19 pandemic. This will help physicians bill for procedures that combat the novel coronavirus.

The New Code and Descriptor

“87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique” This CPT code is now effective as the industry standard for reporting testing of the novel coronavirus in the US healthcare system. Further information can be found on The American Medical Association website. Short, medium, and long descriptors can be accessed at the AMA website.

Operation Update for Quest National Services

At this time we are running business as usual, but we are closely monitoring guidelines from the Center of Disease Control (CDC), World Health Organization, OSHA, and decrees from our state and federal government. Our office is considered “Low Exposure” due to the minimal occupational contact we have with the general public, our Orlando headquarters is in a 4-story building shared with many tenants across different business platforms; our Waco office has numerous tenants across a variety of business platforms as well. We certainly can’t control who comes in and out of our buildings but we can control who comes in and out of our facilities. We’re taking the following measures to maintain our level of service to our clients:

• We are requiring all employees to maintain a clean and sanitary work environment
• Our administration is doing hourly surface-level cleaning
• Visitors are required to utilize sanitizer upon entering our facility and be in general good health
• We as an organization are doing everything to keep our employees healthy by maintaining a sanitized work environment
• If our office closes due to any circumstances we do have a contingency plan to ensure claims and payments continue processing as normal

Our entire management team is monitoring on a daily basis federal, state, and local mandates and our plan is to continue operating as normal until otherwise instructed and/or mandated by our government. Our primary goal to ensure that you know we are here if you have questions. If you or your office is interested in exploring a free telemedicine platform, please contact us to learn more.

During the COVID-19 public health emergency, telemedicine offers medical practices the ability to continue caring for their patients both with and without COVID-19. In order to mitigate exposure of patients who are sick or at-risk due to other conditions and to protect the healthcare workers and community, practices are strongly encouraged to use telemedicine and telehealth services whenever possible. They are also encouraged to consider establishing protocols and procedures for use by practice staff and clinicians. Now in a full state of emergency, Medicare, Medicaid, and many private insurance restrictions related to telemedicine have been lifted.

Patients can be at home and non-HIPAA compliant technology is now allowed.

There is no cost-sharing for COVID-19 testing. In addition, to encourage use by patients, Medicare, Medicaid, and some private insurances are allowing practices to waive cost-sharing (copays and deductibles) for all telehealth services. Many prior authorization activities are being paused. There is one caveat here. It seems patients who have been tested for CORVID-19 and have a diagnosis code related to CORVID-19 will have their co-pays, co-insurance, and deductibles waived. With this said there are payers who are waiving all patient cost-sharing but it is on a plan by plan basis.

The Basics of Billing for Telemedicine Services

Telemedicine billing seems to change from day to day, by the payer and by state. While all payers have some form of formal policy in place for how to bill for telemedicine, the COVID-19 impact on insurance is changing almost daily to meet the needs of so many specialties that normally would not need to use these services.

There are a few items to discuss what to expect from different payers, regardless of the state they are in.

How Are Self-Funded Plans Affected?

These are plans where the employer pays for the medical services provided to their employees. These plans are administered by a third-party administrator and currently have full discretion on which services they will allow. Currently, most are not reimbursing providers for telemedicine services.

What Services Are Covered and How Is This Determined?

Many payers will only pay for the services under the patient’s current insurance plan. If it is not a covered service, the payer will not cover the cost and the cost will defer to the patient. The verification of the patients’ eligibility to ensure telemedicine services are covered is essential and begins at the provider’s office.

How Are Private Payers Affected?

Private payers may have their own manner of billing for telemedicine services. For instance, modifiers, procedure codes, and the place of service may be different from that of Medicare and Medicaid.

How is Payer Reimbursement Seen on an Individual Level?

Each payer reimbursement has to be looked at individually. There is not a standard reimbursement rate across the board. Some pay at a reasonable and customary rate or a fixed rate. A few payers will pay at the provider’s contracted rate and of course many will deny your claim. In every one of the aforementioned scenarios, the billers working on the claims will place the claim in a queue for further investigation with the payer to determine if additional funding will be forthcoming.

Updates to Insurance Information

Insurance companies are updating their websites almost daily, so we have a team solely dedicated to finding the answers. Of course, the providers and their teams are also receiving insurance direct correspondence. By working together we can keep everyone updated.

Steps You Can Take

Many doctors aren’t being fully compensated for their telemedicine services. This is largely in part due to the complexity of medical billing for telemedicine services. But we’re here to help. With telemedicine coding and solutions to help you transition during COVID-19. Contact us

Outsourcing your medical billing can seem like a daunting or complex decision for many providers. Although not every outsourcing company is created equal, outsourcing is a great decision for providers across the board.

Although every practice is unique, this guide will help give you the understanding you need to organize a billing department from scratch, audit your own financial collections process, and find out how to grow your revenue.