News & Analysis

July 1, 2019
Briefings on APCs

In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.

July 1, 2019
Briefings on APCs

CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.

June 28, 2019
News & Insights

The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!

June 26, 2019
News & Insights

Most proposed solutions to surprise medical bills will negatively affect provider organizations, according to a Moody’s Investors Report released June 20. However, even in the absence of a solution, the growing awareness of the scope and impact of surprise medical bills will harm providers’ relationships with patients.

June 26, 2019
Medicare Insider

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! 

June 24, 2019
News & Insights

Q: My team is asking me if we should combine pre-admission testing (PAT) visits with the surgery bill. I'm thinking no because some of the PAT services are not routine for the surgery. However, isn't there a rule about services that can't be billed separately prior to surgery?

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