February 1, 2020
Briefings on APCs

The Medicine section of the CPT Manual includes codes for a variety of services including acupuncture, vaccinations, and behavioral health assessments and is divided into 33 subsections that can make it challenging to navigate.

January 20, 2020
News & Insights

The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) recently filed a lawsuit against the Department of Health and Human Services (HHS) for continuing to reduce payments for hospital outpatient services provided in grandfathered, off-campus provider-based departments (PBD) in the fiscal year 2020 OPPS final rule.

January 1, 2020
Briefings on APCs

If you aren’t yet confused by the site-neutral payment policy changes prompted by CMS apparently ignoring both Congressional intent and the American Hospital Association (AHA) and other impacted hospitals filing suit, you are likely to become so now.

January 1, 2020
Briefings on APCs

The 2020 update to the CPT Manual includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.

November 1, 2019
Briefings on APCs

The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.

November 5, 2019
Briefings on APCs

As of October 1, approximately 1,080 cases of respiratory illnesses and 18 deaths brought on by vaping have been reported in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). Despite continued research into these cases by the CDC and the U.S. Food and Drug Administration (FDA), the specific cause of these illnesses remains unknown.

November 4, 2019
News & Insights

CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.

October 1, 2019
Briefings on APCs

As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.

October 1, 2019
Briefings on APCs

Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.

October 7, 2019
News & Insights

CMS recently announced that it is accepting comments until November 29 on a proposal to collect acquisition cost data from hospitals participating in the 340B drug discount program.

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