Most people associate Chikungunya with a tropical, mosquito-borne illness, not revenue cycle management (RCM). The virus is not yet widespread in many non-endemic regions. Still, recent cases in Europe, especially in France and Italy, as well as past local transmission in parts of the United States and the Caribbean, highlight a need for preparation. Healthcare organizations now have an opportunity to assess whether their revenue cycle systems can adapt quickly to emerging health threats.
The COVID-19 public health emergency changed billing, coding, and reimbursement rules almost overnight, as regulators accelerated the normal process for creating and implementing new diagnosis and procedure codes. With only a few weeks’ notice instead of the usual three to six months, regulators released codes such as U07.1 and the initial exposure Z-codes. Hospitals, EHR vendors, and billing teams had to update systems almost immediately to keep up.
Many hospitals relied on vendor-maintained code lists and standard system updates. Even short delays left organizations and clinicians without the correct codes, using older ones such as pneumonia, for example. That led to coding inconsistencies, claim denials, and payment delays.
Financial incentives raised the pressure. During the pandemic, Medicare offered add-on payments—for example, a 20% bonus for treating COVID-19 inpatients and temporary reimbursement boosts for certain new therapies or technologies. This encouraged hospitals to update their billing systems and adopt news codes quickly, as well as treat patients with new and expensive treatments. Such incentives triggered audits and tighter documentation rules. But once the emergency period ended, before getting paid, hospitals had to prove each COVID case with a positive test within 14 days of admission. Many organizations ended up forming special teams just to review medical records and meet the new requirements.
The crisis also exposed systemic weaknesses. Rushed code creation led to confusion and inconsistent guidance. Temporary hospitals and relaxed documentation rules created records that lacked standard details. Training gaps left coders and clinicians without the support they needed to apply rules correctly.
Some organizations turned those challenges into a catalyst for improvement. These hospitals and health systems moved quickly to integrate new codes, established direct lines of communication with payers, and brought coding, billing, and compliance teams into alignment before problems could escalate.
COVID-19 showed how quickly billing, coding, and reimbursement rules can change. Health systems that managed well adopted a few key practices that revenue cycle leaders can implement now:
Chikungunya may not create major disruption today, but it serves as a reminder that every public health event tests how well revenue cycle systems can adapt. The same is true for the reemergence of measles, which is spreading in several states after years of low incidence. While measles isn’t new, its resurgence highlights a different kind of stress test for healthcare operations: managing reportable diseases that trigger evolving public-health reporting requirements, isolation protocols, and vaccination documentation. These changes can cascade into coding updates, payer policy shifts, and new reimbursement nuances, often with little notice.
By proactively implementing the measures outlined above, RCM teams can stay ahead of disruptions, reduce denials, prevent payment delays, and ensure their organizations remain compliant when billing and documentation requirements shift rapidly.