A new government report finds that Medicare improperly paid acute care hospitals for outpatient services they provided to patients who were inpatients at other facilities. And now Medicare wants the…
Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to…
CMS released a proposed rule that would update the Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System. Here's what you should know about the ASC-related changes:…
Overview On July 31, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining fiscal year (FY) 2018 Medicare payment policies and rates for the Inpatient…
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…
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…
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…
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…
The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing…
The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System…
The Centers for Medicare & Medicaid Services needs to step up its involvement in states' Medicaid integrity programs in order to strengthen oversight and identify overpayments, according to a new…
A new year means new codes and new revenue opportunities for medical practices—but also new challenges to ensure the codes are used correctly. Below is a brief summary of new…
CMS has announced a glitch in the quality reporting measures brought upon by the changes in the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) updates that went into affect…
Five tactics to educate physicians and improve documentation. Q: Our coders and coding auditors often see patterns of incorrect physician documentation. Sometimes the error impacts the MS-DRG, but many times…
Massive ICD-10 code update is responsible for clogging system and leading to reporting problems. ICD-10 has hit yet another snag after massive code updates resulted in a clogged system and…
Since the update from ICD-9 to ICD-10, has your business successfully made the transition to the new coding system, or are you still struggling to keep up? If it’s the…