OPPS

This month's column is all about data--the importance of providers reporting accurate and complete data, as well as CMS having complete, accurate, and consistent data to compute future payment rates.

The CPT Manual divides drug administration services into three different categories:

• Hydration (CPT codes 96360-96361)
• Therapeutic, prophylactic, and diagnostic injections and infusions (96365-96379)
• Chemotherapy and other highly complex drug or highly complex biologic agent administration (96401-96549)

by Kimberly Anderwood Hoy Baker, JD

This week’s note is about changes in the April quarterly OPPS update. 

Despite industry pushback and several delays, ICD-10 implementation has, against all odds, gone relatively smoothly for the vast majority of providers, leading CMS to tout its success in a recent blog post from Andy Slavitt, CMS’ acting administrator. 

There are four newly approved Recovery Auditor issues.

This week’s updates include identifying "No Documentation" medical necessity denials for claims flagged for Recovery Auditor review; Shared System Enhancement 2015 Analysis and Design HUOPCUT hospice period and Health Maintenance Organization processing; and more!

by Valerie A. Rinkle, MPA

This week’s note is about OPPS instructions for coding new drugs. 

There are 10 newly approved Recovery Auditor issues.