If ICD-10-CM/PCS is used to its full potential, it will provide greater detail and a more accurate depiction of patient severity. This level of detail is expected to provide more information about the relationship between a provider’s performance and the patient’s condition.
CMS' 340B FAQ reviews modifiers -JG (drug or biological acquired with 340B drug pricing program discount) and -TB (drug or biological acquired with 340B drug pricing program discount, reported for informational purposes) and requires 340B hospitals to report modifiers even on drugs that are not subject to the discount policy.
This week’s Medicare updates include a fact sheet on the 2018 EHR Incentive Program payment adjustment; transmittals regarding the January 2018 updates to the OPPS, ambulatory surgery center payment system, and physician fee schedule; a memo detailing three categories of sanctions for proficiency testing referrals; and more!
CMS published Special Edition MLN Matters 17033 on December 6 as a reminder that it will not pay acute care hospitals for outpatient services provided to beneficiaries who are covered under a Part A inpatient stay at a separate facility.
Most physicians are familiar with the MIPS quality models: These are the Physician Quality Reporting System (PQRS) measures that we’ve been reporting for years with the old Medicare value-based purchasing program. What we don’t know much about are the new cost efficiency models in MIPS, which are based solely on hospital and physician ICD-10-CM/CPT claims data rather than a clinical abstraction of our medical records.
This week’s Medicare updates include two new advisory opinions; updates to the Physician Compare, Long-Term Care Hospital Compare, and Inpatient Rehabilitation Facility Compare websites; a republished version of the OPPS final rule to include a previously omitted section, and more!
