This week’s release of the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM) proposed rule outlines CMS' specific plans for physician payments, pushing forward with its goal to increase value-based payments and unifying its varied quality, value, and EHR programs.
Major changes in rural health clinic billing requirements has created significant problems processing those claims. Read an expert's take on the current issues facing rural health clinic revenue professionals.
This week’s updates include a transmittal regarding completing and processing Form CMS-1500 Data Set; a transmittal from Provider Reimbursement Manual, Part 1–Chapter 31 on Organ Acquisition Payment Policy; and more!
This week’s updates include reporting principal and interest amounts when refunding previously recouped money on the Remittance Advice; Changes to the laboratory NCD edit software for July 2016; and more!
The new modifier -PO (services, procedures, and/or surgeries furnished at off-campus provider-based outpatient departments [PBD]) and the alternative payment provisions under the Bipartisan Budget Act Section 603 are both related to off-campus PBDs but define "off-campus PBD" slightly differently.
In February 2016, just four months after ICD-10 go-live, sister publication HIM Briefings (formerly Medical Records Briefing) asked a range of healthcare professionals to weigh in on their productivity in ICD-9 versus ICD-10.
Q: Rural health clinics have to start to bill all services on individual lines with HCPCS codes and charges. Is there a way to report these services on a separate line without the appearance of inflating our charges?
A bipartisan coalition of more than two dozen members of the House of Representatives sent a letter to CMS this week asking for a delay in massive proposed changes to the Clinical Laboratory Fee Schedule due to begin January 1, 2017.
Q: I have a question regarding which place of service (POS) code I should use for an orthopedic doctor who did a consultation on a patient that came through the ED. The patient has a spiral fracture of the humerus. The electronic record documents that the patient was admitted to the medical unit on January 31 but was a “boarder” in the ED until February 2, waiting on a room to be available. The orthopedic doctor saw the patient on February 1. The patient did finally receive a room assignment on February 2. In this scenario would I use POS 22 (outpatient hospital) or 23 (ED)? This patient has Medicare.
