Closer Look at the Inpatient Prospective Payment System Final Rule

Yesterday, CMS unveiled the highly anticipated Inpatient Prospective Payment System (IPPS) final rule for the 2021 fiscal year (FY). Chief among the rule’s updated policies is a 2.9 percent increase…

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2021 CPT code set reflects tech innovation, COVID-19 response

Merriam-Webster, which tracks changes to the evolution of the English language, added 535 new words and terms to its dictionary this year, such as “COVID-19,” “physical distancing” and “self-isolate.” E/M…

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We are All One Exposure away from Contracting COVID-19

Sunday morning, I received an email from my father’s assisted living facility, indicating that several residents and staff had tested positive for COVID-19 during their newly implemented routine testing of…

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Continuing Confusion Clouds CS Compliance

During this week’s Monitor Mondays broadcast, Ronald Hirsch, MD, vice president at R1 RCM, reminded listeners how confusing all the waivers and flexibilities associated with the COVID-19 pandemic have been,…

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AMA releases 2021 CPT code set

The first major overhaul in more than 25 years to the codes and guidelines for office and other outpatient evaluation and management (E/M) services was included in today’s release of…

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Things to know about Modifier 25

Modifier 25 is a particularly meaningful coding tool for physicians who bill for evaluation and management (E/M) services. CPT guidelines define the 25 modifier as “Modifier 25 is defined as…

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AMA Telehealth quick guide

The use of telemedicine and remote care services are critical to the safe management of the COVID-19 pandemic, while also ensuring uninterrupted care for 100 million Americans with chronic conditions.…

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CMS Makes COVID-19 Data Reporting a Condition of Participation

COVID-19 data reporting will no longer be voluntary for hospitals participating in Medicare and Medicaid programs, according to a new interim final rule from CMS. The rule released yesterday updated…

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OIG calls on CMS to improve consistency in reviews

Medicare contractors were inconsistent in how they reviewed overpayments during the appeals process, says the Office of Inspector General in a new report.  Although MACs and QICs generally reviewed appealed…

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More COVID-19 Questions Answered

We are getting more sophisticated and knowledgeable about COVID-19, but I am still getting a lot of questions. Many of them are variations on the theme of what to do…

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The Demise of the Medicare Inpatient-Only List – The Myths and Facts

Centers for Medicare & Medicaid Services are proposing to eliminate the inpatient-only list over the next three years. Medicare’s often-misunderstood inpatient-only list may soon be departing, as the Centers for…

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Telehealth “Connecting patients and physicians” beyond the COVID-19 pandemic

The COVID-19 pandemic has driven digital transformation across healthcare at an unprecedented speed. Telemedicine has emerged as an essential tool for maintaining patient/doctor communication during the crisis, enabling clinicians and…

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Turn The Cessation of Elective Surgeries Into an Opportunity to Educate

Under normal circumstances, the biggest difficulty practices encounter when trying to engage in physician education is timing.  Coordinating everyone’s schedules, pulling providers out of the operative and visiting rooms, and…

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CMS Updates Medicare Billing Rules for 20% Add-On COVID-19 Payment

Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent Medicare…

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AFM Outbreak is Expected in 2020

Physicians and parents are warned about the re-emergence of this illness. In October 2018, ICD-10monitor reported initially on acute flaccid myelitis (AFM). The Centers for Disease Control and Prevention (CDC)…

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