Some interesting tidbits of information can be gleaned from the most recent release of the AHA Coding Clinic for ICD-10-CM/PCS to help coders as they work in the new code set.
Per CPT1, modifier -52 is used when a service or procedure is partially reduced or eliminated at the provider's discretion. Such a situation is identified by using the service's usual HCPCS/CPT code and adding modifier -52, signifying that the service is reduced.
The Office of the Inspector General (OIG), which provides oversight of other government entities, released a report in September 2015, OCR Should Strengthen Its Followup of Breaches of Patient Health Information Reported by Covered Entities, that included recommendations on how the entity charged with administering the HIPAA privacy and security rules should improve.
After several delays, ICD-10 implementation is finally upon us. The healthcare industry has spent years planning, training, and testing?and now the moment we have all been waiting for has arrived. But don't breathe a sigh of relief just yet.
Identify the new audit process that will be used by one of the two quality improvement organizations in charge of short stays under the 2-midnight rule.
This week’s updates include an NCD for single chamber and dual chamber permanent cardiac pacemakers; a Medicare Compliance Review of Boca Raton Regional Hospital, Inc., for 2011 and 2012; and more!
This week’s updates include the October 2015 update of the ASC payment system; postpayment review requirements; and more! Click here to read all of this week’s updates.
Being audited is rarely fun. After all, you're probably going to lose money, face a fine, or both. More and more entities are auditing healthcare claims-Recovery Auditors, Medicare Integrity Contractors, MACs, FIs, commercial payers, and on and on.
This week’s note is about the changes to the 2-Midnight Rule in the 2016 OPPS proposed rule. In the 2016 OPPS Proposed Rule, CMS announced that October 1, 2015 they will be transitioning the medical review of inpatient admissions from Medicare Administrative Contractors (MAC) to Quality Improvement Organizations (QIO). This policy will limit the future review of inpatient admissions by the Recovery Auditors and may be related to CMS’ withdrawal of the Request for Quotes for new Recovery Auditors announced July 10.
