Acknowledging comments received from providers regarding policies in the 2016 OPPS proposed rule, CMS is proposing for 2017 that procedures with a HCPCS code-level device offset of more than 40% of the APC costs would be designated as device-intensive procedures and subject to those applicable payment policies.
This week’s updates include a notice of proposed rulemaking for bundled payment models for high-quality, coordinated cardiac and hip fracture care; FY 2017 rate update for inpatient psychiatric facilities PPS; and more!
Q: I have been told by our billers that infusion codes reported in the ED along with an E/M code that has modifier -25 (significant, separately identifiable evaluation and management service on the same day of the procedure or other service) require another modifier. Have I missed an update somewhere along the way?
The Office for Civil Rights released HIPAA phase two guidance July 27. The guidance, a document linking specific audit protocols with document submission requests, included the slide deck from a July 13 webinar for covered entities selected for desk audits, and a list of questions and answered asked during the webinar and via email.
In the 2017 OPPS proposed rule, CMS is proposing to continue its comprehensive APC (C-APC) policy first implemented in 2015 and has proposed 25 new C-APCs for 2017 in addition to the existing 37 C-APCs.
An Oregon academic health center agreed to a $2.7 million HIPAA violation settlement fine and corrective action plan (CAP) after a breach investigation revealed serious HIPAA vulnerabilities throughout the organization, HHS said in a statement released July 18.
When it comes to providing high-quality patient care, most American hospitals simply don’t. That’s if the recent round of five-star rankings from CMS are to be believed. About 1,700 hospitals (39%) earned just three out of five stars, an “average” rating, FierceHealthcare reported.
