Knowledge Base Article

This week we highlight key updates spanning from February 9th through February 15th, 2021.

Resource Spotlight: CMS COVID-19 Toolkit for Healthcare Providers & CDC Toolkit for Older Adults & People at Higher Risk

In January “CMS released a set of toolkits for providers, states and insurers to help the health care system prepare to swiftly administer the vaccine.  These resources are designed to increase the number of providers that can administer the vaccine and ensure adequate reimbursement for administering the vaccine in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover the vaccine at no charge to beneficiaries. In addition, CMS is taking action to increase reimbursement for any new COVID treatments that are approved by the FDA.” The CMS COVID-10 webpage provides information on several key topics such as Coding for COVID-19 Vaccine shots and Medicare Monoclonal Antibody COVID-19 infusion.

The CDC has developed a Toolkit for Older Adults & People at Higher Risk webpage designed to provide “guidance and tools to help older adults and people at higher risk and those who serve of care for them make decisions, protect their health, and communicate with their communities.” Several resources are available on this CDC webpage, for example, COVID-19 Vaccine Resources, Guidance and Planning Documents, Web Resources, FAQs, Fact Sheets and Posters.

February 9, 2021: FDA Authorization for Monoclonal Antibodies Treatment of COVID-19

The FDA announced that they have “issued an emergency use authorization (EUA) for bamlanivimab and etesevimab administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms [about 88 pounds] who test positive for SARS-CoV-2 and who are high risk for progressing to severe COVID-19.” The UEA also authorizes treatment for patients 65 years or older with “certain chronic medical conditions.” As a reminder, the ICD-10-PCS codes for bamlanivimab and etesevimab are included in the list of 21 new procedure codes implemented by CMS with an effective date of January 1, 2021. CMS also has a webpage dedicated to Monoclonal Antibody COVID-19 infusion.

February 10, 2021: CDC Morbidity and Mortality Weekly Report (MMWR): Maximizing Masks

In the MMWR titled Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure, 2021, the authors conducted experiments assessing two ways to improve the fit of medical masks to reduce transmission and exposure of COVID-19. They found that for the user to receive the most benefit from wearing mask(s), a better fit is more effective at slowing the spread of the disease.

The CDC has a dedicated webpage titled Masks Protect You & Me where you can download an educational poster and find links to information about masks (i.e. how to wear masks and how to store and wash masks). 

February 10, 2021: CDC Updates Clinical Considerations for Patients who have received COVID-19 Vaccine

The CDC updated their clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States. One recent change is for vaccinated persons. Specifically, fully vaccinated persons meeting the following criteria are not required to quarantine when exposed to someone with suspected or confirmed COVID-19:

• A person is fully vaccinated (i.e., ≥ 2 weeks following the receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine),
• A person is within 3 months following receipt of the last dose in a series, and
• A person has remained asymptomatic since the current COVID-19 exposure.

February 11, 2021: Alabama Medicaid COVID-19 Emergency Expiration Date Extended

The Alabama Medicaid Agency notes in this Alert that “All previously published expiration dates related to the COVID-19 emergency are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of March 31, 2021, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.”

February 11, 2021: MLN Connects – COVID-19: Revised Clinician Codes Accepted with CS Modifier

CMS included the following information in their Thursday February 11th edition of MLN Connects:

“Effective March 18, 2020, the Families First Coronavirus Response Act requires Medicare Part B to cover beneficiary cost-sharing for provider visits when a COVID-19 diagnostic test is administered or ordered. CMS updated the list of codes (ZIP) that physicians and non-physician practitioners can use with the Cost-Sharing (CS) modifier.

For dates of service on or after January 1, 2021, through the end of the public health emergency, we’ll accept these codes with the CS modifier:

• HCPCS codes G2250, G2251, and G2252
• CPT codes 98970, 98971, and 98972 (These replace HCPCS codes G2061 – G2063, which are accepted for services provided in 2020)  

CPT codes 98966, 98967, and 98968 are accepted for services with the CS modifier provided on or after March 18, 2020.

More information about cost-sharing: Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) (PDF) MLN Matters Article”

February 12, 2021: CDC Guidance – What to Expect After Getting a COVID-19 Vaccine

This CDC webpage provides COVID-19 vaccine information including the following:  

• Common side effects,
• Helpful tips,
• When to call the doctor,
• Scheduling your second shot,
• About the second shot,
• Additional reminders, and
• A printable handout for vaccine recipients.

February 13, 2021: CDC Updates Interim Guidance on Duration of Isolation and Precautions for Adults with COVID-19

The CDC indicates, on this webpage, that “Accumulating evidence supports ending isolation and precautions for adults with laboratory-confirmed COVID-19 using a symptom-based strategy.” Currently, the available data indicates the following:

• Adults with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset,
• Most adults with more severe to critical illness “likely remain infectious no longer than 20 days after symptoms onset,
• Severely Immunocompromised patients have been found to remain infectious beyond 20 days,
• Once recovered from the virus, adults can shed detectable but non-infectious COVID-19 in upper respiratory specimens up to 3 months after illness onset.

The CDC notes that “These findings strengthen the justification for relying on a symptom-based rather than test-based strategy for ending isolation of most patients, so that adults who are no longer infectious are not kept unnecessarily isolated and excluded from work or other responsibilities.”

CDC COVID Data Tracker – United States COVID-19 Cases