News & Analysis

January 1, 2015
Strategies for Healthcare Compliance

The new ICD-10 implementation date is less than a year away, and CMS is gearing up its end-to-end testing process in preparation.

January 1, 2015
Strategies for Healthcare Compliance

Many coders rely on the advice in the American Hospital Association (AHA)'s Coding Clinic to resolve sticky situations with ICD-9-CM coding. However, the AHA will not be transitioning its current guidance to ICD-10-CM. Instead, in January, it began focusing solely on ICD-10-CM questions to help clear up confusion prior to implementation.

January 1, 2015
Strategies for Healthcare Compliance

Q: If someone calls a facility to schedule an appointment for a patient, is it a violation of HIPAA to admit the patient receives care at the practice? For example, the practice where I work often helps victims of domestic abuse. We received a call from a patient's estranged spouse who asked to schedule an appointment for the patient when, in reality, he was trying to determine the whereabouts of his spouse so he could harm her. I realize this is a safety issue but wonder whether it is also a HIPAA issue.

January 1, 2015
Briefings on APCs

CMS proposed that a new HCPCS modifier be appended to every code for a service furnished in a hospital's off-campus provider-based department on both the CMS-1500 claim form for physicians' services and the UB-04 form (CMS Form 1450) for hospital outpatient services in the 2015 OPPS proposed rule. Despite many detailed comments opposing this change, no consensus emerged; therefore, CMS is moving forward with implementing a slightly modified policy.

December 30, 2014
Medicare Insider

This week’s updates include the January 2015 updates to the Integrated Outpatient Code Editor and OPPS. Click the link above to read more about this week’s updates.

December 23, 2014
Medicare Insider

This week’s updates include changes to and billing instructions for various payment policies implemented in the January 2015 OPPS update and new waived tests. Click the link above to read more about this week’s updates.

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