Briefings on APCs

Our experts answer questions about reporting modifier -59 with knee arthroscopies, updates on skin substitute codes, and more. 

Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules. 

It is an unfortunate reality that mood-altering chemical misuse and dependency is rampant throughout the world, especially in the United States.

CMS released the fiscal year 2018 IPPS proposed rule in April, and with it came a bevy of new potential ICD-10-CM codes. The update includes a total of 406 proposed new, revised, and deleted codes to be implemented October 1, 2017. 

Use this 10-question quiz to test your knowledge on 2017 CPT® codes and concepts.  

Our experts answer questions about hitting MUEs on injections and infusions, setting multiple prices for the same CPT codes, payment rates for cancer centers, and more. 

Medicare recently published revisions to its appeals process, focusing on the Administrative Law Judge level of appeal. 

The 2017 calendar year marks the beginning of a new approach to physician payment through the Quality Payment Program (QPP), an initiative created by the Medicare Access and CHIP Reauthorization Act to revise the physician payment system previously updated through the Sustainable Growth Rate.