News & Analysis

March 1, 2019
Briefings on APCs

Coding for knee arthroscopies can be challenging, especially when procedures are performed in multiple compartments of the same knee. Read about anatomy and coding details required to accurately report these procedures.

March 1, 2019
Briefings on APCs

In the 2018 OPPS final rule, CMS removed total knee arthroplasty (TKA) from the inpatient-only (IPO) list effective January 1, 2018. Although some guidance was provided at the time, providers and physicians alike were left confused with a significant number of questions regarding documentation and inpatient status

February 27, 2019
News & Insights

Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.

February 27, 2019
Medicare Insider

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!

February 20, 2019
News & Insights

CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.

February 20, 2019
Medicare Insider

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! 

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