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.
Resolving claims returned with National Correct Coding Initiative edits or Medically Unlikely Edits can be a time-consuming process. Organizations need processes to promote best practices and keep appeals on track, as well as coding and billing policies that address common front-end problems that lead to these edits.
CMS released the fiscal year (FY) 2018 IPPS final rule August 2, updating Medicare payment and polices for patients discharged from hospitals from October 1, 2017, to September 30, 2018.
CMS updated its website for the Quality Payment Program recently with new information clarifying which clinicians will have “special status” and may be exempt from submitting data this year.
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in our documentation and coding practices. In follow-up to last month’s column, let’s discuss additional new codes and their potential impact upon your diagnostic decision-making and documentation.
When Spencer Johnson wrote the iconic book, Who Moved My Cheese? An A-Mazing Way to Deal With Change in Your Work and in Your Life, he probably didn’t have the homecare industry in mind. But with the speed of reimbursement and regulatory issues surrounding us today, he certainly could have.
Whether it is the CPT Manual or Chapter 12 of the Medicare Claims Processing Manual, the definition of a “new patient” is the same for physicians and nonphysician practitioners billing. But that doesn't mean coding and billing for E/M services is clear cut.
