CMS made certain concessions from its proposed site-neutral payment policies required by Section 603 of the Bipartisan Budget Act, but it is still moving forward with implementation January 1, 2017, according to the 2017 OPPS final rule.
Each year, CMS reviews procedures on the inpatient-only list, which consists of services typically provided on inpatients and not payable under the OPPS, to consider whether they are being performed safely and consistently in outpatient departments.
Q: We are a critical access hospital and don’t get paid under the OPPS. We get reimbursed based on our cost of procedures, tests and services. Is modifier –JW (drug amount discarded/not administered to any patient) applicable to us beginning in January?
With the grace period from CMS for reporting unspecified ICD-10-CM codes over, Erica E. Remer, MD, FACEP, CCDS, writes about diagnoses to target for improvement.
The complex anatomy of the arm, wrist, and hand can make coding for procedures on them challenging. Review the bones of the arm and common codes used to report fractures and dislocations.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, writes about methods coders can use to improve the quality and detail of physician documentation to ensure important information is captured.
Q: When coding and trying to sequence a diagnosis such as pneumonia and chronic obstructive pulmonary disease, I understand that there is a “use after” mandate, but how are coders to know which codes the “use additional code” note is providing sequencing advice for?
MS-DRG audits are nothing new, but their frequency has significantly increased over the last two years. In this article, Sam Antonios, MD, FACP, FHM, CPE, CCDS , gives facilities tips to increase the likelihood of overturning MS-DRG denials.
