This week's note from the instructor discusses ways to manage conflicting guidance from CMS regarding add-on code edits and avenues to explore when disputing these edits.
Q: Our facility is interested in conducting audits for observation and drug administration services, but understand they should be considered differently from other services. What details should we take into account before we begin?
It’s no secret that social factors can create sizable barriers for case managers who are working to prevent readmissions, plan for discharges, and meet length of stay targets. Unfortunately, government regulators often don’t factor these issues in when they are looking at quality measures. But that is starting to change.
Rita Luthra, MD, a gynecologist from Longmeadow, Massachusetts, was convicted on April 30 by a federal jury of one count of violation of HIPAA and one count of obstruction of a criminal health care investigation.
This week's note from the instructor discusses ways to manage conflicting guidance from CMS regarding add-on code edits and avenues to explore when disputing these edits.
Creating and using performance standards benefits HIM directors and the many functions they oversee. But with such a wide range of tasks falling under the HIM umbrella, it can be challenging to set practical standards that yield meaningful results. Follow these tips to get the most of out of your department’s standards.
CMS is looking to reduce reporting and documentation requirements for inpatient rehabilitation facilities (IRF) in the 2019 IRF payment system proposed rule, published in the Federal Register May 8. The proposed changes could come as a relief to IRFs that have seen a significant uptick in audits and denials.
This week’s Medicare updates include an interim final rule on durable medical equipment fee schedule rates for rural and non-contiguous areas, an advisory opinion on a possible violation of the federal anti-kickback statute, a quarterly update for the clinical laboratory fee schedule, and more!
A diagnosis in the emergency department is not always guaranteed, but reframing patient encounters can ensure patient needs are met, according to a study in Annals of Emergency Medicine.
The Health Resources and Services Administration recently proposed to delay the implementation of a final rule for the 340B drug pricing program that could lead to fines for drug manufacturers from July 2018 to July 2019.
