News & Analysis

December 1, 2017
Briefings on APCs

Our experts answer questions about reporting –X {EPSU} modifiers, retaining written queries, billing inpatient-only procedures, and more. 

December 1, 2017
Case Management Monthly

Mary, an experienced nurse case manager, has worked on her medical unit for five years. She likes her assignment because it is never boring; she services a wide variety of patients with complex medical problems, and she feels satisfyingly challenged by the intricacies of each case. This is why, when the unit’s nurse manager approaches Mary about transferring a patient to another acute care setting with only a few hours’ leeway, Mary believes she can make it happen.

December 1, 2017
Briefings on APCs

CMS is moving forward with its plan to drastically cut payments for drugs acquired through the 340B drug discount program, according to the 2018 OPPS final rule, released in November. 

December 1, 2017
Briefings on APCs

Although every claim denial should be tracked, not every denial should be appealed. Learn about how and when to appeal Medicare claims denials. 

December 1, 2017
Briefings on APCs

CMS’ policy in the 2018 OPPS final rule to cut reimbursement for drugs purchased through the 340B drug discount program by nearly 30%, accounting for the decrease from average sales price plus 6% to minus 22.5%, is getting a lot of attention from the provider community—and with good reason.

November 30, 2017
Medicare Insider

This week's note from the instructor discusses ways to resolve Medicare billing edits. 

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