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June 21, 2018
Medicare Insider

This week's note from the instructor reviews the impact recent updates to the National Correct Coding Initative (NCCI) edits and Integrated Outpatient Code Editor (IOCE) will have on billing processes.

June 22, 2018
Case Management Monthly

If provisions of the 2019 IPPS proposed rule related to admission orders become a reality in October, case managers could be relieved of a big headache. If this portion of this rule is finalized, CMS would reverse the requirement that a physician’s order must be in the medical record for the hospital to bill for inpatient services under Medicare Part A.

June 22, 2018
Medicare Web

Q: How do we know if our facility is performing too many patient tests? What can we do to prove the tests are medically necessary?

June 22, 2018
Medicare Web

Around a dozen employees of the Washington Health System (WHS) in Washington County, Pennsylvania, have reportedly been suspended for HIPAA violations involving alleged inappropriate access to patient records, according to the Washington County Observer-Reporter.

June 21, 2018
Medicare Insider

This week's note from the instructor reviews the impact recent updates to the National Correct Coding Initative (NCCI) edits and Integrated Outpatient Code Editor (IOCE) will have on billing processes.

June 21, 2018
Medicare Web

Q: Is it a violation of the HIPAA Privacy Rule to make a comment while working at a pharmacy that “we’ve seen a lot of flu cases”?

June 20, 2018
Medicare Web

How can case managers and social workers assist patients in lowering medication costs?

June 20, 2018
Medicare Insider

This week’s Medicare updates include the release of the 2019 ICD-10-CM code set, numerous updates to the OIG Work Plan, a fact sheet detailing how CMS determines qualifying APM status in the Quality Payment Program, and more! 

June 20, 2018
Medicare Web

The Office of Inspector General (OIG) plans to address concerns regarding capitated payment models by putting preauthorization denials under review.

June 20, 2018
HIM Briefings

When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.

June 20, 2018
HIM Briefings

CMS plans to rebrand the Meaningful Use program as “Promoting Interoperability.” In a fact sheet, the agency said that the proposed changes outlined in the IPPS rule are meant to improve the use of EHRs and make it easier for providers to spend time with their patients.

June 19, 2018
Medicare Web

In a continued effort to combat the opioid epidemic, CMS released a roadmap detailing its progress toward addressing the crisis as well as its plans for slowing opioid dependence. CMS noted that while the latest Centers for Disease Control and Prevention statistics indicate the opioid epidemic is not slowing down, efforts aimed at combatting the epidemic must continue.

June 18, 2018

CMS issued change request (CR) 10778 on June 15, with an effective date of July 17, to update Chapter 12 of the Medicare Program Integrity ManualThe proposed update includes details for handling non-responders and insufficient responses to additional documentation requests (ADR) under the Comprehensive Error Rate Testing (CERT) program.