News & Analysis

March 1, 2017
Briefings on APCs

Coders prepared for 2017 with numerous changes to the Official Coding Guidelines for the ICD-10-CM and the addition of many new codes. Quietly waiting in the wings was the updated CPT® Manual for 2017 with its changes waiting to be discovered.

March 1, 2017
Briefings on APCs

As OPPS packaging has increased, providers may be less likely to appeal claims for certain denied charges based on medically unlikely edits, since it would not increase payments. However, providers should consider appeals when services are medically necessary and appropriate, as CMS bases future payment rates on accepted claims. 

March 1, 2017
Medicare Insider

This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!

February 21, 2017
Medicare Insider

This week’s Medicare updates include the delay of the effective date of the Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; a quarterly update to the Medicare Physician Fee Schedule database; ICD-10 coding revisions to National Coverage Determinations; and more!

February 13, 2017
Medicare Insider

This week’s Medicare updates include Advance Care Planning implementation for OPPS claims, revision to State Operations Manual Appendix PP - incorporating revised Requirements of Participation for Medicare and Medicaid certified nursing facilities, and more!

February 13, 2017
Medicare Insider

This week's note from the instructor discusses the billing challenges presented by CMS' Medically Unlikely Edits.

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