Following the guidelines for accurate E/M code assignment

July 1, 2017
Briefings on APCs

Whether it is the CPT Manual or Chapter 12 of the Medicare Claims Processing Manual, the definition of a “new patient” is the same for physicians and nonphysician practitioners billing. But that doesn't mean coding and billing for E/M services is clear cut. 

Comply with medical necessity in outpatient hospital and physician clinic settings

July 1, 2017
Briefings on APCs

As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.

CMS’ QPP proposed rule deserves consideration from providers and hospitals

July 1, 2017
Briefings on APCs

The display copy of the Quality Payment Program proposed rule was released in June, and you can think of this rule as a companion to the Medicare Physician Fee Schedule that typically comes out with the OPPS rule. That means both rules need to be read, understood, and, ideally, commented on by providers.

This month's coding Q&A

July 1, 2017
Briefings on APCs

Our experts answer questions about MUEs on HCPCS codes, appealing claims for noncovered procedures, and more.