As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
In the 2019 OPPS final rule, released Friday, November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
CMS recently released updated guidance on billing intensity-modulated radiation therapy (IMRT) after an OIG audit found a 100% error rate in billing certain IMRT planning services.
To effectively report opioid use, abuse, and dependence, coding and billing professionals must be able to recognize symptoms of these disorders and interpret detailed ICD-10-CM guidelines. Additionally, they must be able to identify complications associated with opioid misuse and overdose.
Modifiers -25 and -27 are used in the outpatient facility setting on E/M services. Learn more about how these modifiers should be applied in accordance with coding and Medicare guidelines.
CMS’ 2019 OPPS proposed rule, released in late July, continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments.
Continuing with numerous specific requests for comment in last year’s OPPS proposed rule, CMS is once again asking stakeholders for feedback on a variety of issues for the 2019 OPPS proposed rule for future potential rulemaking. You may submit comments to the agency until September 24, 2018.
NAHRI’s 2018 Revenue Integrity Symposium is fast approaching, and I am very much looking forward to what’s in store—both at the conference and in the Phoenix area where I reside. Phoenix is truly a beautiful area and the Revenue Integrity Symposium allows you to take in all it has to offer during one of the most beautiful times of year.
