This week’s Medicare updates include a thorough list of alternative payment models that CMS currently operates, the 2019 update to clinical lab fee schedule, a revision to a transmittal regarding medical review of diagnostic lab tests, and more!
2018 was a year of large settlements and high-volume data breaches. According to OCR’s breach report portal, among the more than 250 reported data breaches under investigation, 14 incidents exposed the PHI of more than 100,000 individuals each.
Q: I’m working with our contracting staff to negotiate with a new payer. Is there any potentially problematic contract language I should take under further review?
If you’re involved in utilization review and have found yourself in the uncomfortable position of having to tell a doctor that a patient doesn’t meet criteria for an inpatient stay, you may want to consider different ways to approach these conversations.
Q: Can an ICD-10-CM body mass index (BMI) code be used as a standalone code? If not, what documentation should we look for to justify the use of a BMI code?
