The CMS policy in the 2018 OPPS proposed rule with potentially the largest administrative and financial burden for hospitals should not be finalized, according to the agency’s own advisory panel.
Resolving claims returned with National Correct Coding Initiative edits or Medically Unlikely Edits can be a time-consuming process. Organizations need processes to promote best practices and keep appeals on track, as well as coding and billing policies that address common front-end problems that lead to these edits.
While the American Medical Association supports some of CMS’ proposals for year two of the Medicare Quality Payment Program, it is advising CMS to do more to simplify value-based payments.
You may find significant changes to E/M reporting in the near future, including a pivot away from two key elements — history and physical exam — that largely determine a given level of service for your most common patient encounters.
Two bundled payment programs could be canceled before they begin, and the scope of a third will be significantly limited if a proposed rule released by CMS August 17 is finalized.
