The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for the 2023 Part B Physician…
Revised ICD-10-CM codes for neurocognitive disorders are now in effect, the American Psychiatric Association (APA) has announced The coding changes for major and mild neurocognitive disorders represent "the most consequential"…
New codes become effective Oct. 1, 2022. With the start of fiscal year (FY) 2023 right around the corner, this is a good time for clinical documentation integrity (CDI) professionals…
The Centers for Medicare and Medicaid Services has released the 2023 premiums, deductibles, and coinsurance amounts for fee-for-service Medicare Part A and Part B, and the 2023 Medicare Part D…
When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American Hospital Association (AHA)…
CMS has specific guidelines when defining “incident to” and shared visits. Recently, I was working with a client to help them understand “incident to” billing. We were discussing a situation…
The rise of telehealth during the COVID-19 pandemic pushed up the timetable on telehealth education for medical schools and residency programs. But the relative lack of training using this newer…
Time for CDI checkup. Clinical Documentation Integrity (CDI) programs may be exposing hospitals to unnecessary, costly compliance risks and financial exposure by virtue of their very nature and purpose. When…
Doctors can use a government database to compare their practice patterns to others across the nation, says a former Wall Street trader turned physician. The database, maintained by the Centers…
In 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social, economic, and environmental factors that can affect the health outcomes of disadvantaged…
A new survey of physicians finds they are still facing burdens meeting prior authorization requirements despite a voluntary 2018 agreement among payer groups to reform the practice. The survey was…
The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence…
June 30, 2022 William N. Parham, III, DirectorPaperwork Reduction StaffOffice of Strategic Operations and Regulatory AffairsCenters for Medicare & Medicaid Services7500 Security BoulevardBaltimore, Maryland 21244 Re: Provider Complaints Submission Process…
New codes and guidelines become effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May…
Are you using something other than two-midnight? Here’s why you shouldn’t be. Is there the possibility that your utilization management team and physician advisors are applying InterQual, MCG, or any…
How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be done in various ways, including…