Final ICD-10-CM Codes for 2018 Contain a Few Surprises

The final codes include 322 more changes than what was proposed by CMS in April's hospital IPPS rule. Starting Oct. 1, it will be possible to select a specific ICD-10-CM…

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Medicare Compliance: The Basics for Injury Settlement Recipients

Medicare is a government-provided health insurance program designed to assist certain people with hospital care, medical costs, and other expenses. Qualifying beneficiaries are people who are 65 or older, those…

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OIG Investigates Payments for Ambulance Transports of SNF Patients

Medicare’s Office of Inspector General (OIG) has issued a sixteen-question survey to many ambulance service suppliers. The survey is focused on SNF patients, and specifically why the ambulance service has…

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Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

CMS pushed back the implementation of compulsory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program until 2018. CMS recently delayed the launch date of…

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CMS Tackles Opioid Prescribing

The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing…

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CMS Exempts Two Thirds of Clinicians From MIPS

The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System…

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CMS Told To Crack Down On Improper Medicaid Payments

The Centers for Medicare & Medicaid Services needs to step up its involvement in states' Medicaid integrity programs in order to strengthen oversight and identify overpayments, according to a new…

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How to Take Advantage of New Coding Opportunities in 2017

A new year means new codes and new revenue opportunities for medical practices—but also new challenges to ensure the codes are used correctly. Below is a brief summary of new…

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Everything Doctors Should Know About ICD-10 Glitch

CMS has announced a glitch in the quality reporting measures brought upon by the changes in the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) updates that went into affect…

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How to Successfully Communicate Your Clinical Validation Concerns

Five tactics to educate physicians and improve documentation. Q: Our coders and coding auditors often see patterns of incorrect physician documentation. Sometimes the error impacts the MS-DRG, but many times…

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ICD-10 Glitch Causes CMS To Relax Payment Penalties

Massive ICD-10 code update is responsible for clogging system and leading to reporting problems. ICD-10 has hit yet another snag after massive code updates resulted in a clogged system and…

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Why It’s Essential That MACRA’s Start Be Delayed

This week at a hearing before the Senate Finance Committee, providers heard some comforting statements from Senate leaders and a key official from the Centers for Medicare and Medicaid Services.…

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8 Key Concerns For Physicians in 2016

Physicians often say they feel like the rules, standards and policies regarding the way they practice medicine change all too frequently. In 2016, there are several key issues physicians should…

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