HHS OIG to Conduct Nationwide IRF Audit

The anticipated issue date for the new audit is the 2024 fiscal year. Citing “consistently high error rates,” federal officials announced this week that they will be conducting a nationwide…

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2023 Medicare Final Rules: Long-Awaited, Highly Anticipated

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…

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New ICD-10-CM Codes a ‘Big Switch-Over’ for Neurocognitive Disorders

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"…

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Tips for Preparing for New Coding Changes for 2023

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…

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CMS decreases Medicare Part B monthly premium and deductible

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…

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AHA Responds to Medicare Outpatient Payment Updates for CY 2023

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)…

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AMA Releases 2023 CPT Code Set, Aims to Reduce E/M Coding Burden

The American Medical Association (AMA) has released the Current Procedural Terminology (CPT) code set for 2023, which contains updates that aim to reduce medical coding burden for evaluation and management…

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Splitting Hairs: “Incident to” or Shared Visit

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…

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AMA issues CPT code for orthopedic technology

The American Medical Association has issued a category III current procedural terminology code for Figur8's sensor fusion system combining inertial measurement system and surface mechanomyography. The device was designed to…

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Is Your CDI Program Putting You in the Danger Zone?

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…

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Special Bulletin: CMS Releases IPPS Final Rule

There are no new MS-DRGs in the Final Rule. The fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) Final Rule, released by the Centers for Medicare & Medicaid Services…

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