This week's note from the instructor reviews the FY 2021 updates to interoperability and other inpatient quality programs from the Inpatient Prospective Payment System (IPPS) final rule.
This week’s Medicare updates include the 2022 Medicare Advantage and Part D Advance Notice, the final report from the Coronavirus Commission on safety and quality in nursing homes, a final rule on new specialty care payment models, and more!
This week's note from the instructor discusses FY 2021 IPPS payment factors that currently determine Medicare reimbursement for acute hospital inpatient services.
This week’s Medicare updates include information on the reorganization of the Medicare Program Integrity Manual, updates to three provider-specific fact sheets on COVID waivers, the October 2020 update for the Ambulatory Surgical Center PPS, and more!
This week’s Medicare updates include the FY 2021 IPPS final rule, two new FAQs regarding OIG administrative enforcement during the COVID-19 pandemic, an update to model admission questions for Medicare as a secondary payer, and more!
This week's note from the instructor focuses on the implications of a proposed rule which would redefine the "reasonable and necessary" Medicare coverage standard and would create a new coverage pathway for devices.
This week’s Medicare updates include a new interim final rule with comment regarding COVID-19 data reporting and testing, the October update to the OPPS, a proposed rule on coverage for innovative devices, and more!
This week's instructor note dives into the recent instruction from CMS on requirements for reporting a COVID-19 diagnosis on a claim in order for the claim to be eligible for a payment increase.
This week’s Medicare updates include new guidance on elective procedures for end-stage renal disease patients during the public health emergency, new additions to the OIG work plan, updated data on opioid use in Medicare Part D, and more!
This week's note from the instructor discusses the devastating impact of COVID-19 on skilled nursing and long-term care faciltiies, and it examines ways the federal government is assisting these facilties via regulatory and financial support.
This week’s Medicare updates include a new payment model from the Innovation Center, a proposed decision memo regarding changes to two NCDs, information on the Advisory Panel on Hospital Outpatient Payment meeting, and more!
This week's note from the instructor discusses the impact of the proposed relative value unit (RVU) changes in the 2021 Medicare Physician Fee Schedule (MPFS) proposed rule.
This week’s Medicare updates include the 2021 Quality Payment Program proposed rule, new FAQs regarding COVID-19 topics, the October update to the clinical laboratory fee schedule, and more!
This week's note from the instructor takes a first look at the 2021 Outpatient Prospective Payment System (OPPS) proposed rule and the possibility of sunsetting the inpatient-only list.
This week’s Medicare updates include the release of the Skilled Nursing Facility Prospective Payment System final rule, new ICD-10-PCS codes for therapeutic COVID-19 treatments, the Inpatient Psychiatric Facility Prospective Payment System final rule, and more!
This week's note from the instructor discusses the new home infusion therapy (HIT) benefit and how it could help in the continuum of care during the COVID-19 pandemic.
This week’s Medicare updates include the renewal of the public health emergency for another 90 days, an advisory opinion on charitable organizations resolving medical debt, additional updates to COVID-19 billing FAQs, and more!
This week's note from the instructor reviews coding and documentation requirements for severe malnutrition in light of another OIG review of these types of claims.
This week’s Medicare updates include new FAQ items for COVID-19 billing, updates to the OIG work plan, and another revision to the July 2020 OPPS update.
This week's note from the instructor discusses how to apply the blood deductible under Parts A and B, and it looks at the coverage, billing, and payment rules unique to blood products and related services.
This week’s Medicare updates include the 2021 End Stage Renal Disease Prospective Payment System proposed rule, updates on assorted demonstration models that were paused during the COVID-19 public health emergency, reprocessing instructions for certain IPPS claims, and more!
This week’s Medicare updates include the release of the 2021 ICD-10-CM code set files, a proposed decision memo regarding expanded coverage of a transcatheter mitral valve repair procedure, revisions to the July 2020 OPPS update, and more!
This week’s Medicare updates include the publication of a new ABN form, the release of the 2021 Home Health Prospective Payment System proposed rule, new additions to the OIG Work Plan, and more!
This week's note from the instructor examines places where new guidance from CMS on billing for telemedicine during the public health emergency falls short and what hospitals should do to ensure compliance with these billing policies.
This week’s Medicare updates include new additions to the COVID-19 Medicare billing FAQs, information on billing for clinician services for diagnostic lab tests, the quarterly update to the ambulatory surgical center payment system, and more!
This week's note from the instructor discusses the supervision requirements for certain outpatient services and changes to those requirements during the public health emergency.
This week’s Medicare updates include revisions to billing guidance for using the CR modifier and DR condition code, a table listing changes to CMS Innovation Center models, the July 2020 update to the OPPS, and more!
This week's note from the instructor celebrates NAHRI's Revenue Integrity Week by featuring two revenue integrity case studies on managing the financial impact of COVID-19.
This week’s Medicare updates include new information on the Part D Senior Savings Model, updates to the FAQs on fee-for-service billing during the COVID-19 public health emergency, the release of the 2021 ICD-10-PCS code set, and more!
This week’s Medicare updates include new pricing information for COVID-19 testing, a final rule for Medicare Advantage and Part D plans, updates to the OIG Work Plan, and more!
This week's note from the instructor takes a closer look at certain IPPS proposals, including one that could change the method CMS uses to update MS-DRG payment rates.
This week’s Medicare updates include the 2021 Inpatient Prospective Payment System proposed rule, an FAQ on COVID-19 price transparency regulations, a new toolkit for nursing homes managing COVID-19 cases, and more!
This note from the instructor looks at some of the major provisions in the Inpatient Prospective Payment System (IPPS) proposed rule, including the shortened delay in effective period for the final rule.
This week’s Medicare updates include clarifications on interstate license compacts, a new national coverage determination on acupuncture, a list of hospital outpatient therapeutic services with supervision level changes, and more!
This week's note from the instructor examines new regulatory relief for hospitals regarding outpatient services and telehealth originating site services provided to patients at alternate locations, including their homes.
This week's note from the instructor looks at the timing of the prior authorization program implementation in light of the current COVID-19 public health emergency.
This week’s Medicare updates include recommendations on re-opening facilities for non-emergent, non-COVID-19 care, new guidelines for nursing homes on notification of confirmed or suspected COVID-19 cases, a notice about the Accelerated and Advance Payment Programs, and more!
This week’s Medicare updates include guidance for long-term care facilities on resident transfers during the COVID-19 pandemic, increased payment for certain COVID-19 tests, the FY 2021 inpatient rehab facility prospective payment system proposed rule, and more!
This week’s Medicare updates include proposed rules for the inpatient psychiatric facility, skilled nursing facility, and hospice prospective payment systems; updated guidance on infection control for multiple provider types; additional waivers to relax regulatory requirements during the pandemic, and more!
This week's note from the instructor walks through the various provisions of CMS' interim final rule on policy and regulatory changes during the COVID-19 pandemic.
This week’s Medicare updates include revised guidance on billing for professional telehealth services during the public health emergency, updated provider-specific fact sheets on waivers and flexibilities during the COVID-19 pandemic, revised guidance on EMTALA compliance for COVID-19, and more!
This week’s Medicare updates include a new process for survey activities during the current public health emergency, the passage of the CARES Act, an FAQ on the OIG’s new telehealth policies, and more!
This week's note from the instructor explains the expansion of telehealth and the accompanying billing guidance during the COVID-19 public health emergency.
This week’s Medicare updates include information on expanded telehealth benefits, a chart on contractor pricing for COVID-19 testing, recommendations on elective surgeries during the public health emergency, and more!
This week's Medicare updates include a plethora of information on COVID-19 coverage, payment, and infection control guidance; a new Part D savings model focused on lowering insulin costs; a final rule on interoperability and patient access; and more!
This week's note from the instructor looks at some of the most signifcant changes included in the April 2020 Outpatient Prospective Payment System (OPPS) update.
This week’s Medicare updates include a variety of new information on coronavirus coding and billing, the quarterly update to the OPPS, and the quarterly update to the clinical laboratory fee schedule.
This week's note from the instructor walks through guidance on coding and reporting strategies for coronavirus and provides links to numerous resources for healthcare providers and facilities on managing the coronavirus response.
This week’s Medicare updates include an article on elements necessary to include on orders or prescriptions for certain DMEPOS items, an NCA on colorectal cancer blood-based biomarker tests, a change to the Medicare Physician Fee Schedule database update file, and more!
This week's note from the instructor walks through the nuances of decoding transmittals by using a recent transmittal on national coverage determination changes as a case study.
This week’s Medicare updates include four new items added to the OIG work plan, a new version of the integrated denial notice form, a transmittal implementing numerous regulatory revisions to the State Operations Manual, and more!
This week's note from the instructor discusses the new billing and coverage requirements for opioid treatment programs that went into effect January 1.
This week’s Medicare updates include an article on billing and payment provisions for therapy services under PDGM, an update to the list of DMEPOS items that require prior authorization, a new code to use for coronavirus lab tests, and more!
This week’s Medicare updates include a final decision memo on an NCD for next generation sequencing tests, an update to manual guidance on prior authorization, a guide to billing and coding for mental health services, and more!
This week’s Medicare updates include a Q&A on changes to new technology add-on payments pertaining to antibiotics, a decision memo on coverage for acupuncture as a treatment for chronic low back pain, implementation details for a new ICD-10-CM code for vaping-related disorder, and more!
This week's note from the instructor discusses the new appropriate use criteria reporting requirements for providers ordering advanced diagnostic imaging services in 2020.
This week’s Medicare updates include a new addition to the OIG work plan, the January edition of the Medicare Quarterly Compliance Newsletter, the January 2020 update to the Outpatient Prospective Payment System, and more!
This week’s Medicare updates include a Special Edition MLN Matters article on appropriate use criteria changes, updates to beneficiary notice forms, a beta version of an ICD-10-CM browsing tool, and more!
This week’s Medicare updates include transmittals on new provider specialty codes for opioid treatment programs, the implementation transmittal for the Ambulatory Surgical Center Payment System, correction notices for the 2020 Medicare Physician Fee Schedule final rule and Outpatient Prospective Payment System final rule, and more!
This week's note from the instructor walks through the background of and processes involved in creating a Medicare Coverage Analysis document prior to billing for a clinical trial.
This week’s Medicare updates include details on repayments to outpatient clinic visits at excepted off-campus provider-based departments, a new ICD-10-CM code for vaping-related disorder, an article on home infusion therapy billing, and more!
This week’s Medicare updates include a fact sheet on opioid treatment programs, revisions to skilled nursing facility cost reports, the CY 2020 update to the DMEPOS fee schedule, and more!
This week's note from the instructor examines the impact of the Outpatient Prospective Payment System and Medicare Physician Fee Schedule final rules on critical access hospitals (CAH) and rural health clincis (RHC).
This week’s Medicare updates include the implementation transmittal for the 2020 Medicare Physician Fee Schedule, two Special Edition MLN Matters articles on the implementation of the Patient-Driven Groupings Model, home health billing compliance information, and more!
This week’s Medicare updates include a variety of new initiatives aimed toward improved safety and quality at nursing homes, updated fact sheets on opt-in and voluntary reporting procedures for MIPS, a comment request on an information collection regarding the MOON, and more!
This week's note from the instructor discusses the elimination of the direct supervision requirement for all hospital outpatient therapeutic services effective January 1, 2020.
This week’s Medicare updates include two rules on price transparency, updates to medical review requirements for SNFs, annual updates to the therapy code list, and more!
This week's note from the instructor explores considerations chargemaster coordinators should make regarding routine services in general medical/surgical units, specialty/intensive care units, and incidental nursing or bedside procedure charges.
This week’s Medicare updates include a fact sheet on HIPAA privacy requirements, enrollment information for opioid treatment programs, implementation of end-stage renal disease payment rate updates, and more!
This week's note from the instructor explores coding and billing for the new care management services established by the Medicare Physician Fee Schedule final rule.
This week’s Medicare updates include the Outpatient Prospective Payment System final rule, the Medicare Physician Fee Schedule final rule, a proposed decision memo on genetic testing for cancer, and more!
This week's note from the instructor discusses operational considerations to make while implementing new billing processes for therapy assistant modifiers.
This week’s Medicare updates include the October edition of the Medicare Quarterly Compliance Newsletter, a pair of requests for information on potential usage of artificial intelligence to prevent fraud, Medicare Advantage billing instructions for CAR-T therapy, and more!
This week's note from the instructor reviews the updated Inpatient Prospective Payment System (IPPS) rates published in the correction notice for the final rule.
This week’s Medicare updates includes 2020 payment rates for the Medicare Diabetes Prevention Program, updates to the OIG work plan, guidance on coding for encounters related to vaping illnesses, and more!
This week’s Medicare updates include a pair of proposed rules on revisions to Stark Law, a correction notice for the IPPS final rule, updates to the amount in controversy thresholds for CY 2020, and more!
This week's note from the instructor addresses the broad range of directives included in a recent Executive Order aimed at improving Medicare Advantage and reducing burden on providers.
This week’s Medicare updates include a Special Edition MLN Matters article on diabetes screening tests, revisions to the ambulatory surgical center October payment system update, manual changes related to implementation of the SNF Patient Driven Payment Model, and more!
This week’s Medicare updates include a final rule on revisions to discharge planning requirements, a handful of resources regarding a fraudulent genetic testing scheme, revisions to quality policies and procedures for laboratories, and more!
This week's note from the instructor discusses a change that will be implemented in October to address issues related to device-dependent procedure edits.
This week’s Medicare updates include an OIG review of emergency ambulance transports from hospitals to skilled nursing facilities, revisions to the State Operations Manual regarding critical access hospitals adding provider-based locations, coding revisions for national coverage determinations, and more!
This week's note from the instructor reviews recent clarifications for the use of revenue coes 0942 and 0240 when billing for hospital inpatient Part B services.
