When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.
This week’s Medicare updates include the release of the 2019 ICD-10-CM code set, numerous updates to the OIG Work Plan, a fact sheet detailing how CMS determines qualifying APM status in the Quality Payment Program, and more!
The recently released 2019 ICD-10-CM update adds some codes to allow additional diagnoses to be reported while adding others for greater specificity. The update includes more than 600 additions, deletions, and revisions.
This week’s Medicare updates include the July updates for the OPPS and ambulatory surgical center payment system, a new national coverage analysis for vagus nerve stimulation as a treatment for treatment-resistant depression, an advisory opinion related to telemedicine, and more!
CMS announced revised pricing for covered drugs and biologicals in the July 2018 update to the OPPS. Hospitals should thoroughly review all of the updates to ensure any required changes are in place by the stated effective dates.
Healthcare providers are often confused about what a commercial or managed care payer would want in order to approve the claim. Much of this confusion comes from the timing of requirements to ensure reimbursement.
