News & Analysis

October 1, 2021
Case Management Monthly

In December 2020, CMS announced that it would begin a Review Choice Demonstration (RCD) for inpatient rehabilitation facility (IRF) services. The goal: to improve detection and identification of Medicare fraud related to these services.

October 1, 2021
Briefings on APCs

Several CPT modifiers have similar definitions, which can make distinguishing between them challenging. Review guidance for the appropriate application of modifier -51 versus -59 and discontinued service modifiers -52, -53, -73, and -74.

October 1, 2021
Briefings on APCs

ICD-10-CM coding for neuropathies can be challenging given the complexity of these diagnoses and associated complications. Demystify documentation requirements and ICD-10-CM coding for ischemic and hemorrhagic strokes, migraine headaches, and paralysis.

October 1, 2021
Briefings on HIPAA

In its July newsletter, OCR announced a collaboration with the HHS Office of the National Coordinator for Health Information Technology (ONC) to seek user feedback and improvement suggestions on its Security Risk Assessment (SRA) Tool.

September 1, 2021
Briefings on APCs

Review proposed updates to the CPT set for 2022, including new codes for chronic care management, laser interstitial thermal therapy, spinal anesthesia, and more.

September 1, 2021
Case Management Monthly

CMS has reinstated the short-stay reviews and high-weighted DRG reviews originally halted in 2019. The national contract to conduct these reviews was awarded to Livanta, one of the Beneficiary & Family-Centered Care and Quality Improvement Organizations.

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