In December 2020, CMS announced that it would begin a Review Choice Demonstration (RCD) for inpatient rehabilitation facility (IRF) services. The goal: to improve detection and identification of Medicare fraud related to these services.
H.R. 7898 became law on January 5, 2021, and amended the Health Information Technology for Economic and Clinical Health (HITECH) Act to require the secretary of HHS to consider certain recognized security practices of covered entities and business associates when making certain determinations, and for other purposes.
CMS finalizing plans to remove the inpatient-only list, only to propose a reversal less than a year later, has introduced challenges for case managers.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
Several CPT modifiers have similar definitions, which can make distinguishing between them challenging. Review guidance for the appropriate application of modifier -51 versus -59 and discontinued service modifiers -52, -53, -73, and -74.
