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.
This week’s Medicare updates include an article for health care professionals to use as a resource throughout the 2019-20 flu season, an OIG data brief on using CERT data to identify high-risk home health agencies, revisions to the Claims Processing Manual regarding billing for Part B inpatient services, and more!
This week's note from the instructor looks at the ongoing judicial actions pertaining to discharge appeal rights for Medicare beneficiaries assigned to outpatient status or who have received observation services.
This week’s Medicare updates include information on Hurricane Dorian waivers for Florida, the Carolinas, and Georgia; a final rule on provider enrollment changes aimed at minimizing the risk of fraudulent practices; the October update of the ambulatory surgical center payment system, and more!
This week's note from the instructor offers tips and tricks to simplify the process of distinguishing routine and research costs when billing for clinical trials.
This week’s Medicare updates include information on waivers and extensions for places affected by Hurricane Dorian, the October updates for the OPPS and DMEPOS fee schedule, the implementation on a policy revising requirements for appeals signatures, and more!
This week’s Medicare updates include a Special Edition MLN Matters article on the new documentation requirements for cost reports, revised manual instructions related to the implementation of the Patient-Driven Groupings Model, an OIG review of the impact of price substitutions based on average sales price data, and more!
This week's note from the instructor explores proposals from the 2020 Medicare Physician Fee Schedule proposed rule and items for revenue cycle staff to consider commenting on before the comment period closes September 27.
This week’s Medicare updates include a new tracking sheet for a national coverage analysis of transcatheter mitral valve repair procedures, the October 2019 update to drug and biologicals HCPCS codes, the October 2019 update to the Medicare Physician Fee Schedule database, and more!
This week's note from the instructor delves into the key policies from the 2020 Inpatient Prospective Payment System (IPPS) final rule which revenue cycle staff need to familiarize themselves with prior to implementation on October 1, 2019.
This week’s Medicare updates include the release of the 2020 ICD-10-CM coding guidelines, a decision memo on chimeric antigen receptor T-cell therapy, a booklet on critical access hospital requirements, and more!
This week's note from the instructor examines some of the key proposed policies from the Outpatient Prospective Payment System proposed rule, including policies on general supervision, site neutrality, 340B payments, and price transparency.
This week's note from the instructor checks in on the current status of the 340B court case in light of CMS' request for comments in the 2020 OPPS proposed rule on ways to remedy the 340B reimbursement adjustments.
This week’s Medicare updates include the July edition of the Quarterly Compliance Newsletter, a guide on how to use diagnosis codes to help identify unreported abuse or neglect, provider compliance tips regarding documentation for diabetic supplies, and more!
This week's note from the instructor discusses ways clinical trial billing rules apply to more than just research and how they affect billing for free drugs or devices.
This week’s Medicare updates include an article on waivers available in Louisiana to assist in the recovery efforts from Tropical Storm Barry, a proposed rule on increased flexibilities for long-term care facilities, a proposed decision memo on coverage of acupuncture for low back pain, and more!
This week's note from the instructor looks at a few issues pertaining to rural health clinics that remain unsolved either due to conflicting or lacking guidance from CMS.
This week’s Medicare updates include the CY 2020 Home Health Prospective Payment System proposed rule, a series of OIG reports on hospice deficiencies, the new interest rate for Medicare overpayments and underpayments, and more!
This week's note from the instructor addresses some of the issues arising from the start of a new Quality Improvement Organization (QIO) contracting cycle.
This week’s Medicare updates include a decision memo for an ambulatory blood pressure monitoring NCD, another extension of enforcement discretion for the laboratory date of service exception policy, a fact sheet on proper billing processes for DMEPOS items delivered to inpatients, and more!
This week's note from the instructor discusses the circumstances surrounding a bill introduced in Congress in March that would include observation care in the three-day stay requirement for skilled nursing facility (SNF) coverage.
This week’s Medicare updates include the release of the 2020 ICD-10-CM codes, new voluntary appeals settlement options for inpatient rehabilitation facilities, updated instructions for organ transplant programs, and more!
This week's note from the instructor reviews a recent CMS report on the Innovation Center's progress in testing new payment and service delivery models.
This week’s Medicare updates include the extension of a final rule on improvements for acute care and critical access hospitals, an OIG report on potential abuse and neglect at skilled nursing facilities, a revision to the July update of HCPCS codes, and more!
This week's note from the instructor looks at the progress CMS has made in reducing burden through the Patients over Paperwork initiative and explores potential topics for providers to comment on to drive additional improvement.
This week’s Medicare updates include an OIG review of a hospital’s skewed wage data, a court-ordered explanation on methodology for certain IPPS calculations, a memo on changes to timelines on investigations for deaths associated with restraint or seclusion, and more!
This week’s Medicare updates include an in-depth article on CAR T-Cell billing, a transmittal on changes to postpayment additional documentation request sample letters, a correction to the Inpatient Rehabilitation Facility Prospective Payment System proposed rule, and more!
This week's note from the instructor discusses NCCI edit changes and ways to resolve edit issues before they become an issue at late stages of the billing process.
This week’s Medicare updates include a series of OIG reviews of home health billing, the July 2019 update of the OPPS and I/OCE, a report on how health IT influences care coordination in accountable care organizations, and more!
This week's note from the instructor provides an overview of the Medicare Physician Fee Schedule Database and how to track any changes or updates to it.
This week’s Medicare updates include a final rule on Medicare Advantage drug pricing, the quarterly update for HCPCS drug/biological codes, an update to claim status and claim status category codes, and more!
This week's note from the instructor delves into an issue with inpatient-only procedures that may result from wording in the 2019 Inpatient Prospective Payment System (IPPS) final rule.
This week’s Medicare updates include a new Home Health Change of Care Notice, a final rule regarding drug pricing transparency, new information on patient relationship categories and codes, and more!
This week’s Medicare updates include a draft of guidance for hospital co-location, additional instructions for implementation of the Patient-Driven Groupings Model, a proposed rule on changes of ownership for accrediting organizations, and more!
This week’s Medicare updates include the Inpatient Prospective Payment System proposed rule, the announcement of a set of voluntary payment models focusing on primary care, the quarterly update for the End-Stage Renal Disease Prospective Payment System, and more!
This week’s Medicare updates include proposed rules for the inpatient rehabilitation facility, inpatient psychiatric facility, and skilled nursing facility payment systems; a proposed rule on the 2020 hospice payment rate update; a draft of new guidance on ligature risks; and more!
This week’s Medicare updates include a final rule introducing new benefits for Medicare Advantage, details on a nationwide Medicare brace scam, a proposed decision memo for ambulatory blood pressure monitoring, and more!
This week's note from the instructor discusses some of the ethical concerns case managers and potentially other types of healthcare professionals may face when utilizing technology such as social media, mobile devices, and electronic health portals.
This week’s Medicare updates include the Medicare Advantage and Part D rate announcement and final call letter, a fact sheet on the Preclusion List, updates to provider self-disclosure settlements, and more!
This week’s Medicare updates include a proposed decision memo for transcatheter aortic valve replacements, clarification on a transmittal regarding evaluation and management coding, an article on edits for OPPS providers with multiple service locations, and more!
This week's note from the instructor is the second in a two-part series that discusses the intricacies of Medicare's inpatient hospital lifetime reserve days benefit and the challenges associated with it.
This week’s Medicare updates include a transmittal on billing for hospital Part B inpatient services, a quarterly update to the Medicare Physician Fee Schedule database, the April 2019 update of the Ambulatory Surgical Center Payment System, and more!
This week's note from the instructor explores the requirements for reporting clinical laboratory commercial and Medicare Advantage payment data to CMS.
This week’s Medicare updates include several new additions to the OIG Work Plan, the April 2019 Outpatient Prospective Payment System update, corrections to the Medicare Physician Fee Schedule final rule, and more!
This week's note from the instructor uncovers a possible issue with the national jurisdiction of Noridian Healthcare Solutions as the sole Supplemental Medical Review Contractor (SMRC).
This week’s Medicare updates include comment dates for a proposed rule on interoperability and patient access, changes to the quality rating system for Nursing Home Compare, a fact sheet on the DMEPOS Competitive Bidding Program for 2021, and more!
This week’s Medicare updates include an in-depth MLN Matters article on the clinical laboratory fee schedule data collection and reporting requirements, a memorandum on skilled nursing facility late adopters, a listing of public meetings on requests for revisions to HCPCS codes, and more!
This week's note from the instructor explores the new codes for the post discharge home visit waiver included in the April 2019 update of the Medicare Physician Fee Schedule.
This week’s Medicare updates include an OIG review of skilled nursing facility services and the three-day inpatient hospital stay requirement; the release of the 2019 hospital OPPS two times run document; a transmittal about new HCPCS codes subject to and excluded from CLIA edits; and more!
This week’s Medicare updates include a proposed decision memo on coverage for CAR T-Cell therapy, an updated OIG work plan, the announcement of a new emergency services payment model, and more!
This week's note from the instructor is the first in a two-part series that discusses the intricacies of Medicare's inpatient hospital lifetime reserve days benefit and the challenges associated with it.
This week’s Medicare updates include a transmittal implementing the new skilled nursing facility payment model, the introduction of a new app displaying Medicare coverage information, a transmittal about updates to provider enrollment policies, and more!
This week's note from the instructor discusses recent guidance from CMS on how to handle the removal of TKAs from the inpatient-only list and the 2 midnight rule.
This week’s Medicare updates include a Special Edition MLN Matters article on the removal of total knee arthroplasty from the inpatient-only list, manual changes related to functional reporting requirements and outpatient therapy caps, the April 2019 quarterly average sales price drug pricing files, and more!
This week's note from the instructor covers coding, billing, and payment rules for provider-based departments located off campus, including new rules that became effective for dates of service on and after January 1, 2019.
This week’s Medicare updates include four new additions to the OIG work plan; provider compliance tip sheets on tracheostomy supplies, ventilators, canes, and crutches; a national coverage analysis on acupuncture as a treatment for low back pain; and more!
This week's note from the instructor reviews the policies and procedures surrounding the implementation of a new provider specialty code for Undersea and Hyperbaric Medicine.
This week’s Medicare updates include a transmittal implementing quarterly updates to the DMEPOS competitive bidding program files, a transmittal implementing 14 newly waived CLIA tests, the quarterly update to the NCCI procedure-to-procedure edits, and more!
This week's note from the instructor examines the initial implementation of CMS' new price transparency policy and tactics facilties have employed to comply with publicly posting a list of machine-readable standard charges.
This week’s Medicare updates include the January 2019 update of the Ambulatory Surgical Center Payment System, new guidance on delivering immunosuppressive drugs to a different address, an update to the appeals prioritization process, and more!
This week's note from the instructor discusses the intent of the 2019 price transparency policy and shares last-minute resources to help providers achieve compliance with the regulation.
This week’s Medicare updates include a thorough list of alternative payment models that CMS currently operates, the 2019 update to clinical lab fee schedule, a revision to a transmittal regarding medical review of diagnostic lab tests, and more!
This week’s Medicare updates include an FAQ on the new price transparency rule for 2019, an update to the Medicare Benefit Policy Manual to include new payment policies for rural health clinics, a fact sheet on the Value-Based Purchasing Program for FY 2019, and more!
This week's note from the instructor provides guidance on what type of information should be provided to patients during the informed consent process of clinical trials.
This week’s Medicare updates include a proposed rule regarding changes to the Medicare Advantage program regulations and Prescription Drug Benefit program, a review of hospital wage data to determine vulnerabilities in the hospital wage index system, the Fall 2018 semiannual report to Congress, and more!
This week's note from the instructor explores payment implications for a new virtual check-in service, which will be implemented effective January 1, 2019, as a provision of the 2019 Physician Fee Schedule final rule.
