News & Analysis

July 3, 2018
News & Insights

Case managers must begin to learn the skill of brokering for care. The goal of private payers is to provide the most cost-effective care that meets medical necessity for services and increases likelihood for recovery. 

July 2, 2018
News & Insights

What is a good strategy for sharing denials data with the medical staff to ensure they understand weaknesses?

July 2, 2018
Briefings on HIPAA

A legislative effort is underway to align some of the provisions of 42 CFR Part 2—the privacy regulation that governs the use and disclosure of substance use disorder information maintained by programs known as “Part 2” programs—with HIPAA.

July 1, 2018
Briefings on APCs

The fiscal year (FY) 2019 ICD-10-CM code update, released on June 11, includes 279 code additions, 143 revisions, and 51 invalidations. The number of changes is significantly less than the past two years, which makes me think we are getting back to the “norm” of expected yearly changes.

July 1, 2018
Briefings on APCs

In the April 2018 OPPS update transmittal, CMS announced new HCPCS code C9749 (repair of nasal vestibular lateral wall stenosis with implant[s]), effective April 1, 2018.

July 1, 2018
Briefings on APCs

Our experts answer questions about drug units in the charge description master, reporting multiple IV pushes with subsequent infusions, and more.

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