The Hierarchical Condition Categories (HCC) risk-adjustment methodology is beginning to surface more frequently in both the acute and primary settings. Use these expert tips to help improve complete, compliant HCC capture.
This week’s Medicare updates include several changes to the July 2018 update of the Outpatient Prospective Payment System, the introduction of a new Data Element Library to help support interoperability, a request for information regarding possible changes to Stark Law, and more!
When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.
This week’s Medicare updates include the release of the 2019 ICD-10-CM code set, numerous updates to the OIG Work Plan, a fact sheet detailing how CMS determines qualifying APM status in the Quality Payment Program, and more!
This week’s Medicare updates include an OIG study on increases in reimbursement totals for brand-name drugs in Part D, a Special Edition MLN Matters article on hospice billing and claims processing, the July 2018 quarterly update to the Durable Medical Equipment fee schedule, and more!
Although compliant querying is clearly spelled out in inpatient CDI, where patient encounters can last three to five days, it’s more complex in the fast-paced ambulatory world where single patient encounters are shorter and may be spread over a year’s time. Experts weigh in on the best approach to effective, compliant outpatient queries.
