News & Analysis

September 1, 2014
Briefings on APCs

When CMS releases rules, the length can be intimidating. But even at a relatively slim 700 pages, the 2015 OPPS proposed rule isn't able to include details on each of the changes CMS is planning. This is probably a good thing?otherwise the rules could be thousands of pages long. Updates like codes being moved around or status indicators changing often aren't described in full in the narrative text, necessitating a deeper look at the addenda CMS releases as Excel® files on its website.

September 1, 2014
Briefings on APCs

Modifier -25 (significant, separately identifiable E/M service by the same physician on the day of a procedure) is used to distinguish visits from procedures on the same day.

It is not used to distinguish observation from a visit service on the same day.

August 12, 2014
Medicare Insider

This week’s note is about recently published final rules. Click the link above for more information and an in-depth analysis.  

August 7, 2014
Medicare Insider

On the heels of the 49th anniversary of the signing of Medicare and Medicaid into law, the Centers for Medicare & Medicaid Services (CMS) projected today that the average premium for a basic Medicare Part D prescription drug plan in 2015 will increase by about $1, to an estimated $32 per month, continuing its historically low growth rate. 

August 1, 2014
Briefings on APCs

Our experts answer questions on coding chronic illnesses, reporting screw removals, E/M denials, and more.

August 1, 2014
Briefings on APCs

The July quarterly I/OCE update from CMS brought few new APCs or edit updates, but did deliver new modifier -L1. Hospitals will use the new modifier to submit outpatient laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) in certain circumstances to claim separate payment.

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