New COVID-19 work-safety rule targets health care facilities

The AMA raised serious concerns about the lack of notice and short comment time frame for a new Occupational Safety and Health Administration (OSHA) regulation regarding measures that health care…

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Physicians Beware: The Feds Are Cracking Down on Free Services Offers

The federal government is increasingly levying enforcement actions against health-care providers. For example, in fiscal year 2010, the federal government initiated 378 civil actions and 647 criminal actions, as compared…

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CMS Seeks Health Equity, Telehealth in Physician Fee Schedule Rule

CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a…

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Condition Code 44: Use Wisely

The billing Code 44 and the required UR process have become intertwined. Utilization review teams and physician advisors have the same goal as the Centers for Medicare & Medicaid Services…

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CMS and Discharge Planning Conditions of Participation

Hospitals are advised to offer choice to patients in terms of nursing homes, home care agencies, long-term acute-care hospitals, and inpatient rehabilitation facilities. It has now been over 18 months…

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OSHA’s COVID-19 Emergency Standard for Healthcare Employers

OSHA has issued an Emergency Temporary Standard (ETS) for occupational exposure to COVID-19 that is applicable only to healthcare employers. The genesis for this ETS came one day after President…

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Is COVID-19 the PDx When Present with COPD Exacerbation?

The underlying etiology is sequenced first and the manifestation, or the presentation of the disease process, is coded second. Recently I was listening to a podcast called Coder vs. CDI…

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Clarifications make E/M changes easier to implement

Refinements continue for the evaluation and management (E/M) office-visit and outpatient documentation and coding reforms that took effect this year, and these include technical corrections updates to the Current Procedural…

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CMS Releases 2022 Proposed Inpatient Prospective Payment System Rules

On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The…

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ICD-11 Prep: Examining Prominent Changes in Preparation for the Transition

Since the World Health Organization (WHO) announced the release of the International Classification of Diseases, Eleventh Edition (ICD-11) in 2019, the opinion among industry insiders regarding U.S. adoption of the…

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