CMS announced another round of changes to its Bundled Payments for Care Improvement program recently and said that while participation thus far has been voluntary, it may become mandatory starting as early as 2024.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO, looks at the implications of a recent OIG brief on how Medicare Advantage organizations could use national provider identifiers (NPI) to monitor for fraud, waste, and abuse.
Laura Evans, CPC, and Julia Kyles, CPC, break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
In the U.S., tympanostomy tube insertion is the most common ambulatory surgery performed on children under 15, according to StatPearls. Debbie Jones, CPC, CCA, reviews common types of ear infections and CPT coding for myringotomies with tympanostomy tube insertion.
The agency is proposing methods to alleviate burden on hospitals that have been under strain for the past year, while also asking for feedback that may shape future data reporting and rate-setting.
With the inpatient-only (IPO) list set to be phased out, HIM departments need to prepare for the larger operational and financial impacts. Consider how these changes will affect your organization.
It’s always been easy to show financial return on investment for inpatient CDI endeavors, but the monetary value of outpatient programs is increasing dramatically year after year, making outpatient CDI reviews more attractive to many healthcare organizations.
Effective management of claim edits and denials is a cornerstone of a sound revenue cycle. See how your organization compares to others and what you can do to improve.
National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) can throw a wrench in the Medicare billing process, delaying appropriate revenue. Learn how to apply recent guidance and best practices to resolve challenging edits.