This week’s Medicare updates include proposed rules for the FY 2019 Skilled Nursing Facility Prospective Payment System (PPS), Inpatient Rehabilitation Facility PPS, Inpatient Psychiatric Facility PPS, and Hospice Wage Index and Payment Rate Update; the quarterly listing of Medicare program issuances; a guide on multi-payer model requests for advanced APM determinations; and more!
CMS recently clarified the use of modifier -KX (requirements specified in the medical policy have been met) in response to an Office of Inspector General report that identified conflicting guidance that resulted in $4.6 million in improper payments.
This week’s Medicare updates include the release of the 2019 Inpatient Prospective Payment System proposed rule, the publication of the feedback CMS received following a request for information on initiatives to improve the quality of healthcare while reducing cost, the announcement of the new Data-Driven Patient Care Strategy, and more!
Correct, complete documentation is the foundation of a sound medical record and compliant reimbursement, but getting that foundation in place can be challenging. Clinicians are juggling critical tasks in a high-stress situation, and administrative burden of electronic documentation and the disconnect that results from spending more time looking at a screen than a patient are often cited as the primary factors in physician burnout. Enter the medical scribe.
A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.
Medicare billing edits such as National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) must be resolved at their root cause so that they do not continue to occur on claim
