If CMS’ late April release of a change request requiring reporting of the previously optional modifier -JW (drug amount discarded/not administered to any patient) by July 1 seemed too sudden, the good news is many other providers—and the agency—agreed.
CMS' coding modifiers are not always used to report clinical components of a service. Sometimes they can be used in order to provide information about how a service relates to Medicare coverage policies.
CMS is expected next week to discuss potential changes to 2-midnight rule audits by Quality Improvement Organizations after quietly suspending the reviews in early May.
The healthcare industry is focused on the triple aim: reducing healthcare costs, improving patient experience, and improving the health outcomes of populations. Healthcare organizations will no longer be paid based on the volume of services provided but rather on the value of care delivery.
Those who regularly attend the annual AHIMA Convention and Exhibit no doubt have seen the exceptional quilt created each year by AHIMA member Katy Sheehy, MPA, RHIA, and sponsored by the Dames of Distinction to be bid at auction. The quilt is auctioned in support of the Linda Culp Memorial Scholarship fund, which was established in memory of the late Linda Culp, a former HIM professional, hospital chief executive officer, and AHIMA member. If you have seen the quilt, you have probably asked yourself, "Who are these people?"
Sepsis isn’t the only clinical condition with an updated definition that could impact coding and documentation. A task force of the National Pressure Ulcer Advisory Panel (NPUAP) recently changed terminology related to pressure ulcers that includes new terms that are not yet part of ICD-10-CM.
CMS recently released its seventh maintenance update for National Coverage Determinations to incorporate ICD-10 and other coding updates, which may require providers to contact Medicare Administrative Contractors regarding previously submitted claims.
The addition of thousands of new diagnosis and procedure codes in a single year might typically be cause for concern for hospitals, with ICD-9-CM updates before the 2012 code freeze rarely topping more than a couple hundred per year.
Few in the healthcare industry would argue that the way the government currently pays for drugs is the most cost-effective, efficient, and equitable method possible.
