News & Analysis

July 1, 2019
Briefings on APCs

CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.

July 1, 2019
Medicare Web

Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?

June 28, 2019
Medicare Web

The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!

June 28, 2019
Case Management Monthly

A medical center case manager must deal with a patient who presents a Medicaid insurance card that is not hers on admission.

June 28, 2019
Medicare Web

Q: What is the appropriate ICD-10-CM code assignment for acute cellulitis in a patient with Type 2 diabetes?

June 27, 2019
Medicare Web

Q: Is it a HIPAA violation if it is discussed among coworkers why another coworker left work early for being ill? 

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