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June 29, 2017
Medicare Insider

This week's note offers guidance on CPT E/M codes for new versus established patients and addresses OIG reports on E/M codes audits.

June 28, 2017
Medicare Insider

This week's Medicare updates include a Quality Payment Program proposed rule; new guidance for formatting plans of correction; clarification regarding Conditions for Coverage for End Stage Renal Disease facilities; and more!

June 28, 2017
HIM Briefings

In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities.

June 28, 2017
Medicare Web

Q: Should we merge the care coordinator role in nursing with the RN case manager role in order to upgrade nursing care?

June 28, 2017
HIM Briefings

Technology has transformed HIM. Today, challenges in the HIM department include EHRs, alphanumerical codes, quality metrics, and technology devices like scanners.

June 28, 2017
Medicare Web

With healthcare billing growing in complexity each year, healthcare organizations must take extra steps to maximize reimbursement and maintain compliance. 

June 27, 2017
Medicare Web

Medicare Advantage beneficiaries often see greater racial disparity than traditional Medicare patients where readmissions are concerned, according to a recent Health Affairs study.

June 26, 2017
Medicare Web

We have trouble billing multiple units of injections and infusions—mostly CPT add-on codes 96375 (injection, each additional sequential intravenous push of a new substance/drug) and 96376 (injection, each additional sequential intravenous push of the same substance/drug provided in a facility)—that are done during observation stays and exceed the medically unlikely edits number. What is the correct way to bill these and get paid?

June 26, 2017
Briefings on HIPAA

This month's security Q&A answers readers' questions about accounting of disclosures, providing information to marketing departments, unencrypted emails, and terminating BAAs.

June 26, 2017
Medicare Web

The release of the Quality Payment Program proposed rule introduced virtual groups as a way to reduce burden on small practices and clinicians. While the MACRA legislation laid out the initial concept of virtual groups, this proposed rule revealed many more details about how virtual groups will function. 

June 23, 2017
Medicare Web

Q: When multiple procedures are performed, is it appropriate to charge an additional set-up fee? For example, a facility performs a colonoscopy and an esophagogastroduodenoscopy, which took a total of 20 minutes in the procedure room. The facility charged two set-up fees plus an additional five minutes of OR time. Would this be considered a duplicate charge?

June 23, 2017
Medicare Web

State-sponsored hackers may be planning to exploit multiple Microsoft vulnerabilities to launch large-scale attacks against healthcare organizations, HHS warned.

June 23, 2017
Case Management Monthly

The ED will soon no longer serve as the welcome mat for the community because the role of the entire hospital in the continuum of healthcare services is going through rapid transformation.