Analyze key provisions in the 2026 Inpatient Prospective Payment System (IPPS) proposed rule to understand potential updates to Medicare inpatient coding and billing.
Recent data shows that all improper payments for bacterial culture lab tests can be traced back to insufficient documentation. Review CMS' provider compliance tip to prevent denials.
This week’s Medicare updates include the April 2025 OPPS Addendum A and B files, revisions to the modifier -JW and -JZ policy HCPCS code list, and more!
Practices upped their use of modifier 59 (Distinct procedural service) in recent years, adding nearly 1 million 59-appended claims to the most frequently reported same-day procedural codes.
On November 1, 2024, CMS released its final rule describing calendar year 2025 policies and rates for Medicare’s Outpatient Prospective Payment System and the final rule was published in the Federal Register. This article is a comprehensive overview of all the major highlights, allowing coders to stay informed about key updates and navigate the changes throughout the year.
