January 1, 2013
Briefings on APCs

Hospitals earned a big win with drug payments this year in the 2013 OPPS final rule, released November 1. CMS decided to finalize its proposal to follow the statute and reimburse facilities at the average sales price (ASP) plus 6%.

January 1, 2014
Briefings on APCs

The number of patients using Medicare Advantage (MA) is rapidly growing, making Hierarchical Condition Categories (HCCs) an increasingly important concept for revenue cycle staff to understand in order to guarantee reimbursement.

January 1, 2013
Briefings on APCs

As part of the 2013 OPPS final rule, CMS finalized a clarification to 42 CFR 419.2(b) that could cause confusion in the future if hospitals are audited by third-party payers or by Medicare contractors who do not fully understand the intent of the language or how CMS develops payment rates, says Jugna Shah, MPH, president of Nimitt Consulting based in Washington, D.C.

January 1, 2014
Briefings on APCs

Jugna Shah, MPH, writes about the perfect storm that led to the release of the 2014 OPPS Final Rule.

January 1, 2014
Briefings on APCs

Our experts answer questions on port reassessment, laparoscopies, reporting multiple biopsies, rejected drug claims, post-reduction film, nipple revisions, and more.

January 1, 2013
Briefings on APCs

Our coding experts answer your questions about reporting fetal ultrasound codes, bell curve for E/M visits, and billing for wasted drugs.