News & Analysis

May 1, 2013
Briefings on APCs

CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.

May 1, 2013
Briefings on APCs

The AMA revised the molecular pathology codes in the CPT® Manual in 2012, but at that time CMS did not adopt the codes as it was still debating whether and how to change the reimbursement system for these services going forward. For CY 2013, CMS elected to recognize the codes, which meant it had to finalize how to pay for them. While CMS did not change pamyent for these services under the Clinical Laboratory Fee Schedule (CLFS) despite industry pressure, its change to the new codes means a change in the payments providers can expect this year and in the future.

May 1, 2013
Briefings on APCs

Successful appeals can actually lead to CMS policy changes. Facilities have been successfully appealing to receive Part B payments after a Medicare review contractor denied a Part A stay as not medically necessary. As a result, CMS is changing its policy on rebilling for Part B services.

May 1, 2013
Strategies for Healthcare Compliance

Q. Can paper patient records be kept in a public storage unit? The storage company we are considering has a digital entry at the main gate. We would also have a keyed lock on the storage unit door.

April 1, 2013
Briefings on HIPAA

Q. I was told I would be "terminated" if I did not sign a release of medical information. Is this a valid authorization?

April 1, 2013
Case Management Monthly

Learning objectives

  • Identify why case managers should be concerned about the issue of ­imaging utilization
  • Develop strategies to improve imaging utilization

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