A patient came to our endoscopy suite for a bronchoscopy due to an abnormal chest X-ray. The physician documented that a transbronchial lung biopsy was obtained from the right upper lobe and the right lower lobe. What would be the correct CPT® codes to report?
With the expansion of telehealth services, providers for both the originating site and distant site can also count on the expansion of Medicare contractor audits.
The shift from fee-for-service to value-based programs for outpatient payment systems has increased the need for outpatient CDI staff to review documentation for pertinent clinical factors.
Providers should be preparing for another rulemaking cycle from CMS as we hit April, with the IPPS rule expected to include a discussion on how the existing payment system can address new and emerging cellular and gene therapies.
CMS instructed Medicare Administrative Contractors (MAC) to review previously denied 2018 outpatient therapy claims reported with modifier -KX. However, because MACs might not automatically review all denied therapy claims, providers will need to initiate the process.
This week’s Medicare updates include several corrections to transmittals issued regarding April 2018 payment system updates, four new resources for those participating in the Quality Payment Program via an alternative payment model, an OIG review of outpatient physical therapy billing, and more!
