News & Analysis

January 15, 2020
News & Insights

HHS’ Health Resources and Services Administration (HRSA) should step up oversight of hospitals participating in the 340B drug discount program, the U.S. Government Accountability Office (GAO) recommended in a recent report.

January 13, 2020
News & Insights

Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?

January 8, 2020
Medicare Insider

This week’s Medicare updates include transmittals on new provider specialty codes for opioid treatment programs, the implementation transmittal for the Ambulatory Surgical Center Payment System, correction notices for the 2020 Medicare Physician Fee Schedule final rule and Outpatient Prospective Payment System final rule, and more! 

January 6, 2020
News & Insights

Q: How do we report total observation time when during the encounter the patient also received bundled services that include observation?

January 1, 2020
Briefings on APCs

The 2020 update to the CPT Manual includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.

January 1, 2020
Briefings on APCs

One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.

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