Last year, as ICD-10 implementation approached, organizations throughout the U.S. reported varying levels of comfort with regard to readiness and understanding of the impact of ICD-10 on physician workflow. For some, it was business as usual. For other physicians, ICD-10 became one more check box on the list of reasons to leave practice.
CMS proposed an extensive five-year, two-phase plan to overhaul Part B drug payments for physicians and hospitals in March outside of the normal OPPS rulemaking cycle that could be implemented as early as this fall.
This week’s release of the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM) proposed rule outlines CMS' specific plans for physician payments, pushing forward with its goal to increase value-based payments and unifying its varied quality, value, and EHR programs.
On March 31, CMS released special edition MLN Mattersarticle SE1607 regarding new enforcement editing requirements for the Medicare Benefit Policy Manual (Internet-Only Manual 100-02), Chapter 6, section 70.3, which describes coverage and billing of Partial Hospitalization Program (PHP) services. This guidance is likely due to the significant problems with PHP service claims and coding highlighted in the 2016 proposed and final OPPS rules. This guidance is effective for PHP services furnished on or after July 1.
The Provider Roundtable, established in 2003 to give CMS the benefit of providers' input and guidance on critical healthcare delivery issues, has issued a call for new members who have a strong interest in improving Medicare reimbursement under various payment systems.
This week’s updates include reporting principal and interest amounts when refunding previously recouped money on the Remittance Advice; Changes to the laboratory NCD edit software for July 2016; and more!
The new modifier -PO (services, procedures, and/or surgeries furnished at off-campus provider-based outpatient departments [PBD]) and the alternative payment provisions under the Bipartisan Budget Act Section 603 are both related to off-campus PBDs but define "off-campus PBD" slightly differently.
In February 2016, just four months after ICD-10 go-live, sister publication HIM Briefings (formerly Medical Records Briefing) asked a range of healthcare professionals to weigh in on their productivity in ICD-9 versus ICD-10.
A bipartisan coalition of more than two dozen members of the House of Representatives sent a letter to CMS this week asking for a delay in massive proposed changes to the Clinical Laboratory Fee Schedule due to begin January 1, 2017.
