The brain is the most complex component of the central nervous system, consisting of approximately 100 billion neurons that communicate via an exponential number of synapses. Coding for the brain can seem almost as complex. Brush up on ICD-10-CM/PCS coding for the brain.
Success under MACRA relies on the capture and maintenance of trustworthy clinical and financial patient data sets. HIM professionals understand root cause analysis, the mechanism of reporting data, and the importance of data consistency and integrity.
The OIG will be scrutinizing how CMS collects overpayments, according to a recent update to its Work Plan. The agency will be looking at whether CMS followed recommendations to improve and increase collections.
A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.
Medicare billing edits such as National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) must be resolved at their root cause so that they do not continue to occur on claim
Under what circumstances would it be appropriate for a patient who does not meet inpatient criteria to be registered as outpatient receiving observation services?
A CMS fact sheet reminds providers to brush up on their MIPS knowledge in regard to the quality performance category. This performance category is worth 50% of providers’ final MIPS score for 2018, and providers who demonstrate improvement from their performance in the category in 2017 could earn bonus points this year.
Providers should be preparing for another rulemaking cycle from CMS as we hit April, with the IPPS rule expected to include a discussion on how the existing payment system can address new and emerging cellular and gene therapies.
