Each new CMS fiscal year, MS-DRG weight and classification changes in the CMS IPPS final rule are closely scrutinized by the coders and clinical documentation improvement (CDI) specialists on the CDI team to identify any potential impact on documentation capture and code assignment processes.
Provider-based clinics and departments are increasingly common, but the rules for provider-based billing can often be confusing, especially given recent changes to modifiers and place of service codes.
Developing a strong denial management program may be one of the best ways to minimize the productivity and financial losses anticipated with the transition to ICD-10. By determining a baseline for denials and proactively identifying denial trends, organizations can efficiently resolve issues and reduce costs. An effective denial management program will help organizations to track, trend, resolve, and ultimately prevent denials.
CMS released its proposed rule for stage 3 of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs (https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-0668...) in March. The intention is to simplify the EHR Incentive Programs, drive interoperability, and allow providers to further focus on patient care. The rule proposed a transition to a single meaningful use stage, with stage 3 being the final stage in the program. It would incorporate portions of stages 1 and 2.
As more hospitals adopt EHRs over paper records, the amount of data stored electronically steadily increases. However, the usefulness of this data diminishes if it does not translate to meaningful information that hospitals can use for operations surrounding registration, treatment, billing, coding, and research.
