In the 2018 OPPS proposed rule, CMS proposed a change to the current clinical laboratory date-of-service policies for molecular pathology tests and for Advanced Diagnostic Laboratory Tests.
The specificity of ICD-10 ushered in a stronger focus on clinical coding audits. From internal reviews to external coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind.
The Joint Commission continues to provide excellent resources to help healthcare organizations stay ready for surveys, as well as resources that help them meet and understand the intent of standards and elements of performance.
As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.
Whether it is the CPT Manual or Chapter 12 of the Medicare Claims Processing Manual, the definition of a “new patient” is the same for physicians and nonphysician practitioners billing. But that doesn't mean coding and billing for E/M services is clear cut.
Accurate clinical documentation is the bedrock of the legal medical record, billing, and coding. It is also the most complex and vulnerable part of the revenue cycle.
