Facility evaluation and management (E/M) coding is based on the facility resources utilized to provide medical care. Because CMS has not created national E/M guidelines for emergency department (ED) services, providers must create their own criteria for each visit level. Review your organization’s ED E/M leveling policies to ensure compliance.
CMS’ Hospital Outpatient Payment (HOP) panel made numerous recommendations at its annual meeting August 19 for the agency to consider ahead of the release of the 2020 OPPS final rule—with the panel and other stakeholders urging CMS to be more transparent with its responses and release of data.
Starting January 1, 2020, the education and operations testing period will kick off, and organizations will be required to report appropriate use criteria (AUC) consultation information. Learn what you can do now to help your organization prepare to report AUCs in 2020 and beyond.
The January 1, 2020, deadline for reporting Appropriate Use Criteria (AUC) for advanced diagnostic imaging is fast approaching—but organizations can’t wait until the new year to prepare.
Behavioral health is a highly specialized area of coding that many coders and billers are unfamiliar with. There are hundreds of ICD-10-CM codes for mental disorders with unique characters to specify symptoms and complications.
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
