This week’s Medicare updates include new hospital appeals settlement options, revisions involving the addition and deletion of ICD-10-CM codes from certain NCDs, details on the partial settlement of a 2-Midnight policy court case, and more!
According to a report published by Change Healthcare, 23.9% of claim denials are due to errors during front-end revenue cycle processes such as registration and eligibility.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
Providers in some states may soon discover a big hurdle to clear when seeking to report a set of apheresis services after one MAC tightened up physician supervision requirements.
The Joint Commission continues to provide excellent resources to help healthcare organizations stay ready for surveys, as well as resources that help them meet and understand the intent of standards and elements of performance.
