Providers in some states may soon discover a big hurdle to clear when seeking to report a set of apheresis services after one MAC tightened up physician supervision requirements.
The Office of Inspector General found CMS improperly awarded an estimated $4.6 million in reimbursement for immunosuppressive drugs billed with modifier -KX (requirements specified in the medical policy have been met). The OIG also said CMS should revise guidance on modifier -KX because current guidance is confusing and contradictory.
In the 2018 OPPS proposed rule, CMS proposed a change to the current clinical laboratory date-of-service policies for molecular pathology tests and for Advanced Diagnostic Laboratory Tests.
In a series of press releases, CMS announced certain public health emergency policies are in effect for the parts of Texas, Louisiana, and Florida hit by Hurricanes Harvey and Irma.
The new ICD-10-CM codes for FY 2018, effective October 1, 2017, represent significant changes in some of our documentation and coding practices. Review the changes to the FY 2018 ICD-10-CM Official Guidelines for Coding and Reporting (the Guidelines), which must be embraced if our documentation, coding, and billing is to withstand compliance scrutiny from outside auditors and accountability agents.
A successful outpatient CDI program will be invaluable to an organization, but without a focus and plan the program can become overwhelmed and ineffective. HIM and CDI need to work closely together to identify the greatest areas of opportunity in the outpatient setting and ensure that goals are aligned throughout the continuum of care.
You may find significant changes to E/M reporting in the near future, including a pivot away from two key elements — history and physical exam — that largely determine a given level of service for your most common patient encounters.
The 2018 OPPS proposed rule includes potential changes to 340B drug discount payments, the inpatient-only list, packaging for low-level drug administration services, and more.
CMS wants your thoughts on its 2018 OPPS proposed changes. In various places in the proposed rule, CMS specifically asks providers to comment on the proposals. You may submit comments to the agency until September 11, 2017.
