News & Analysis

Note from the instructor: April Quarterly OPPS Update Corrects and Clarifies Items from January

March 2, 2016
Medicare Insider

This week’s note is about changes in the April quarterly OPPS update. 

This month's coding Q&A

March 1, 2016
Briefings on APCs

Our experts answer questions about Composite APCs, modifier –CT, and more.

Data accuracy is key for CMS to set payment rates, but guidance must be standardized

March 1, 2016
Briefings on APCs

This month's column is all about data--the importance of providers reporting accurate and complete data, as well as CMS having complete, accurate, and consistent data to compute future payment rates.

Pay attention to the hierarchy when reporting drug administration services

March 1, 2016
Briefings on APCs

The CPT Manual divides drug administration services into three different categories:

  • Hydration (CPT codes 96360-96361)
  • Therapeutic, prophylactic, and diagnostic injections and infusions (96365-96379)
  • Chemotherapy and other highly complex drug or highly complex biologic agent administration (96401-96549)

 

Newly approved Recovery Auditor issues-02/17/2016

February 16, 2016
Medicare Insider

There are four newly approved Recovery Auditor issues.

This week in Medicare updates–02/17/2016

February 16, 2016
Medicare Insider

This week’s updates include identifying "No Documentation" medical necessity denials for claims flagged for Recovery Auditor review; Shared System Enhancement 2015 Analysis and Design HUOPCUT hospice period and Health Maintenance Organization processing; and more!

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