This week’s Medicare updates include two new fact sheets on Merit-based Incentive Payment System (MIPS) policies, a Special Edition MLN Matters article on proper coding for certain laboratory tests, instructions regarding the new skilled nursing facility Advance Beneficiary Notice (ABN) forms; and more!
A patient came to our endoscopy suite for a bronchoscopy due to an abnormal chest X-ray. The physician documented that a transbronchial lung biopsy was obtained from the right upper lobe and the right lower lobe. What would be the correct CPT® codes to report?
With the expansion of telehealth services, providers for both the originating site and distant site can also count on the expansion of Medicare contractor audits.
The shift from fee-for-service to value-based programs for outpatient payment systems has increased the need for outpatient CDI staff to review documentation for pertinent clinical factors.
Providers should be preparing for another rulemaking cycle from CMS as we hit April, with the IPPS rule expected to include a discussion on how the existing payment system can address new and emerging cellular and gene therapies.
Many hospitals find that their Patient Safety Indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions. That may be because they fail to realize that the Agency for Healthcare Research and Quality has a risk-adjustment methodology that predicts each of these PSIs and is dependent upon the documentation and coding of PSI-sensitive risk factors.
