News

The fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) proposed rule makes broad efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. The proposed rule, released April 27, also eliminates sweeping changes to MS-DRG rate-setting finalized in the 2021 IPPS final rule.

Q: What revenue code should be attached to HCPCS codes M0239 (intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring) and M0243 (intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring)? We set it up as revenue code 260 but are getting edits to change it to 771. What are your thoughts and suggestions?

Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2x4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)?

CMS is reminding providers to ensure that Medicare claims for telehealth are correctly billed. The agency issued broadly expanded telehealth services as part of its response to the COVID-19 public health emergency.

Q: Case managers must know the difference between capacity and competence when working with patients of any age. How would you explain the difference between those two essential terms?

Cancer Treatment Centers of America and Midwestern Regional Medical Center (CTCA) based in Zion, Illinois, reported a breach last month potentially affecting 104,808 individuals, according to the Office for Civil Rights (OCR) breach report.

The American Medical Association and dozens of specialty physician groups sent a letter to CMS on April 7 urging the agency to delay the implementation of new prior authorization requirements slated to go into effect this summer for certain outpatient services.

Q: We're looking for ways to bring our CDI and coding teams together to improve documenation and coding for appropriate Hierarchical Condition Categories (HCC) capture. Are there any recommended models and should other departments or individuals be working alongside them?

Q: Is it appropriate to report an E/M code for visit services provided in conjunction with a wound care procedure?

CMS should rescind denials recently issued to certain off-campus provider-based departments (PBD) that applied for the mid-build exception under the 21st Century Cures Act, the AHA said in a March 25 letter to CMS.