Many hospitals find that their Patient Safety Indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions. That may be because they fail to realize that the Agency for Healthcare Research and Quality has a risk-adjustment methodology that predicts each of these PSIs and is dependent upon the documentation and coding of PSI-sensitive risk factors.
In today’s uncertain regulatory environment, establishing an internal audit process is more important than ever to ensure proper billing and reimbursement. Follow these eight steps to establish an efficient internal audit and compliance program.
This week’s Medicare updates include a special edition MLN Matters article on billing requirements for OPPS providers, an updated OIG work plan, a final decision memo for an NCD on genetic testing for cancer patients, and more!
Changes to HCPCS and CPT® codes, drug and biological payments, and a new separately payable procedure code are coming in April. The transmittal announcing the updates also includes clarification on the application of the modifier –FY payment reduction.
Coding and documentation can make or break providers’ success under the Quality Payment Program. An examination of specific measures reveals coding and documentation areas to focus on.
This week’s Medicare updates include an advisory opinion on whether an excluded individual could be employed by an entity involved in federal healthcare programs; a pair of fact sheets on the cost and advancing care information performance category policies for MIPS in 2018; a video for medical offices on the new Medicare cards; and more!
