Doctors Would Report Opioid Diagnosis Codes Under Deal

Ohio doctors would report the specific diagnosis of every patient who receives a prescription painkiller under a tentative agreement reached Friday with the Kasich administration. The 11th-hour compromise between the…

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Why We Need To Stop Calling Physicians “Providers”

It’s a change in nomenclature that’s come a bit out of the blue over the last few years. The forces appear to be aligning to gradually push the word “doctor”…

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New EHR Alert Increases HCV Screening Among Baby Boomers

Implementation of an electronic health record-based prompt significantly increased hepatitis C screening rates among baby boomers in primary care. According to the researchers, HCV screening among adults born between 1945…

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DOJ Charges Hundreds With Opioid-Related Fraud

The U.S. Department of Justice (DOJ) arrested 412 individuals, including 115 licensed medical professionals, across the country for alleged involvement in health care fraud schemes totaling around $1.3 billion in…

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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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How to Avoid TCM Coding Denials

• CPT code 99495 (TCM with moderate medical decision complexity and a face-to-face visit within 14 days of discharge) • CPT code 99496 (TCM with high medical decision complexity and…

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ICD-10: Abide By These Rules When Coding Foreign Bodies

Know when to apply these secondary codes. Foreign bodies (FBs) entering through one of the three ENT-specific pathways is a relatively common occurrence. While these situations are found primarily with…

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Price Gouging in the ER: Patients Often Overcharged

Emergency departments across the United States charge adult patients 340% more than what Medicare pays for services, but minorities and the uninsured receive the biggest bills, according to new research…

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Patient Safety Jeopardized by EHR Downtime, JAMIA Says

Downtime events in hospitals that shut down the functionality of the electronic health record can result in serious patient safety risks, according to a recently published study in the Journal…

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Final ICD-10-CM Codes for 2018 Contain Some Surprises

Revisions include 322 more changes than CMS proposed in April The final updated ICD-10-CM codes for 2018, posted on the Centers for Medicare and Medicaid Services’ (CMS) website, contain 360…

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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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Understanding the Basics of Bundled Payments in Healthcare

How do bundled payments fit into the growing value-based reimbursement ecosystem? The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for…

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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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