Valerie A. Rinkle, MPA, CHRI , reviews what providers need to know about the latest payment model from CMS’ Centers for Medicare and Medicaid Innovation.
CMS continues to focus on site-neutral payment policies and keeping payments down for 340B-acquired drugs in the 2021 OPPS proposed rule, released in early August. Read about these proposals which if finalized, will impact hospital billing and payment starting January 1.
Dee Jones, CFO, describes eight ways 340B covered entities can optimize their 340B programs to gain immediate operational efficiencies while accelerating cash flow and savings.
Medicare’s rules for reporting blood products and applying the Part B blood deductible can be confusing. Judith L. Kares, JD , writes about unique HCPCS reporting and billing rules for blood products and related services reimbursed under the OPPS.
Familiarize yourself with notable code updates in the 2021 Medicare Physician Fee Schedule (MPFS) proposed rule, including new E/M reporting guidelines and CPT® codes for lung biopsies, auditory testing, and chronic care management.
Familiarize yourself with proposed updates to the Medicare Physician Fee Schedule (MPFS), including plans to significantly revise the E/M coding guidelines and extend telehealth flexibilities beyond the COVID-19 public health emergency.
CMS released the calendar year (CY) 2021 MPFS and OPPS proposed rules on August 3, introducing new CPT codes, reducing the PFS conversion factor by nearly 11%, and seeking commentary on how to gradually eliminate the inpatient only list.
Bill Wagner, CHPS, CPCO , unpacks findings from a survey conducted by KIWI-TEK, a medical coding company in Indianapolis, that asked 157 coders how the novel coronavirus (COVID-19) pandemic has impacted their finances, workflow, and career prospects.
Cathy Farraher Nakhoul, RN, BSN, MBA, CCM, CCDS , describes simple actions you can take to show appreciation for providers and make education unobtrusive during the novel coronavirus (COVID-19) public health emergency.
Valerie Rinkle, MPA, CHRI , breaks down updated CMS guidance for reporting virtual clinic visits and other telehealth services rendered at on- and excepted off-campus provider-based departments.
Recently published CMS guidance clarifies billing requirements for services rendered via telecommunications technology during the public health emergency. Valerie Rinkle, MPA, CHRI , breaks down the updated guidance as it applies to outpatient services provided at alternative care sites such as patient homes.
CMS on April 30 released an interim final rule with regulatory relief for hospital outpatient departments. In this article, Kimberly A. Hoy, JD, CPC , reviews Medicare provisions that allow outpatient departments to bill services at alternate locations during the novel coronavirus (COVID-19) public health emergency.
Review up-to-date novel coronavirus (COVID-19) documentation tips, ICD-10-CM and CPT coding guidance, and advice for ensuring billing compliance during the public health emergency.
Coding audits are commonly used to determine the need for focused coder education and training. Learn about key considerations for conducting coding audits and summarizing significant audit findings.
Physician practices have started reopening to patients but are not expecting a return to normal anytime soon. They continue to struggle with staffing shortages and lost revenue due to COVID-19 restrictions.
Read up on new CMS policies that expand COVID-19 care, ramp up diagnostic testing, and loosen restrictions on billing for telehealth services during the public health emergency.
Practices that have experienced a shutdown or a near-shutdown during the COVID-19 national public health emergency need to adhere to state regulations for re-opening. In addition, they must consider the impact that re-opening would have on staff members and patients impacted by the pandemic.
The Office for Civil Rights’ (OCR) enforcement discretion statement seems to open a whole new world of options for providers and patients. However, experts have warned providers that they can still get in a lot of trouble if they are not careful about how they use technology.
Coders will find a wide range of CPT and HCPCS Level II codes that have been assigned medically unlikely edits (MUE) this year. Review new MUE values that went live January 1 for codes involving drug injections as well as E/M, radiology, and therapy services.
As with any new clinical documentation integrity (CDI) initiative, there are many possible starting points for outpatient CDI. Review advice from healthcare professionals at Trinity Health on how to successfully implement an outpatient CDI program.
