The Government Accountability Office (GAO) recommended that CMS assess and strengthen documentation requirements and medical reviews to more effectively prevent improper payments.
Telehealth services are likely to promote health, wellness, and disease management, providing an avenue to offer efficient, high-quality care while supporting value-based care in a cost-effective manner. Although the benefit of telehealth is obvious and its value is continually highlighted by CMS, it appears the services are underutilized.
Providers will find significant leeway in how they can approach and report advance care planning services for physicians given CMS’ open-ended coding requirements, which should push the already strong growth of the codes to new heights.
Hospital coders must develop and adhere to internal E/M coding guidelines and CPT guidance to accurately report visits to the ED. In addition, because ED coding encompasses professional and facility billing, they may need to scour provider documentation to determine the correct E/M service level for both bill types.
This week’s Medicare updates include a transmittal on billing for hospital Part B inpatient services, a quarterly update to the Medicare Physician Fee Schedule database, the April 2019 update of the Ambulatory Surgical Center Payment System, and more!
A recent study found that hospitals may see lower revenue and higher uncompensated care costs in states that implement Medicaid work requirements. States-specific Medicaid program designs may help to mitigate the potential impact, depending on how many beneficiaries lose coverage.
