News & Analysis

March 8, 2017
HIM Briefings

In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.

March 7, 2017
Medicare Insider

This week’s Medicare updates include the April 2017 Update of the Hospital Outpatient Prospective Payment System; the April 2017 Update of the Ambulatory Surgical Center Payment System; an National Coverage Analysis for Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD); and more!

March 1, 2017
Medicare Insider

This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!

February 21, 2017
Medicare Insider

This week’s Medicare updates include the delay of the effective date of the Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; a quarterly update to the Medicare Physician Fee Schedule database; ICD-10 coding revisions to National Coverage Determinations; and more!

February 13, 2017
Medicare Insider

This week's note from the instructor discusses the billing challenges presented by CMS' Medically Unlikely Edits.

February 13, 2017
Medicare Insider

This week’s Medicare updates include Advance Care Planning implementation for OPPS claims, revision to State Operations Manual Appendix PP - incorporating revised Requirements of Participation for Medicare and Medicaid certified nursing facilities, and more!

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