ICD-10 implementation was always expected to result in a drop in coding productivity and accuracy, but the impact has been much lower than anticipated, according to a recent white paper from the AHIMA Foundation.
Last week, CMS published information on a “temporary pause” to the 2-Midnight reviews by the QIOs. Before I cover some details on the pause, I also wanted to share some upcoming events where HCPro regulatory specialists will be speaking.
Q: Our surgeons perform a lot of blepharoptosis repairs. Because each patient is different, different amounts of eyelid tissue has to be removed. One of our surgeons wants to set a maximum amount that is included in the procedure and then charge a blepharoplasty to cover anything over and above this maximum. We are trying to figure out how to even start to operationalize this. It seems to us that this is just a “patient differential” in the surgery like you have in any other surgery. Is there any guidance or standard for this?
This week’s updates include the temporary pause of QIO short stay reviews; review of CMS' Pioneer Accountable Care Organization Payment Model first performance year administration; and more!
The Office of Inspector General (OIG) recovered more than $2.77 billion in civil monetary penalties (CMP) during the first half of the year, according to the office’s
In the July quarterly OPPS update, CMS mentions billing physical and occupational therapy and speech-language pathology services provided in support of or adjunctive to comprehensive APC services under revenue code 0940 rather than the NUBC-defined revenue codes. This article helps make sense of the situation.
If CMS’ late April release of a change request requiring reporting of the previously optional modifier -JW (drug amount discarded/not administered to any patient) by July 1 seemed too sudden, the good news is many other providers—and the agency—agreed.
Q: CMS released guidance last summer about not auditing or counting errors for the specificity of an ICD-10-CM code. CMS is not going to count the code as an error as long as the first three digits are correct. Does this apply to medical necessity diagnoses and edits?
